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In women with breast cancer, depressive symptoms are common and should not be overlooked. Because they significantly alter quality of life and are associated with poorer compliance with treatment and a greater risk of death. A French survey presented as part of the ASCO 2024 world cancer congress aimed to determine the factors favoring depression to better prevent it and anticipate its consequences.
20% of women developed depression during treatment and follow-up
To carry out this work, the Gustave Roussy team of researchers relied on the CANTO cohort, promoted by Unicancer, launched in 2012 in 26 centers in France and made up of 14,000 women with localized breast cancer. The study carried out by Doctor Antonio di Meglio, medical oncologist at Gustave Roussy, focuses on possible depressive disorders in 9,087 patients in this cohort. All were followed for six years after diagnosis. All of these women benefited from surgery, approximately 90% from radiotherapy, 82% from hormonal therapy and 53% from chemotherapy.
“This work allowed us to identify several groups of women based on their depressive symptoms.explains Doctor Antonio di Meglio. In total, 70% of them had few or no depressive symptoms, at diagnosis and treatment, during the 6 years of follow-up. Nearly 7% of patients in this study already had depressive disorders at the time of diagnosis, disorders which resolved very quickly after active treatment (surgery, chemotherapy, radiotherapy). On the other hand, 20% of these women developed depression during the treatment phase or during the six-year follow-up, even though they did not necessarily have depressive disorders before diagnosis.“.
Age, BMI and socio-economic level linked to depression risk
The active treatment phase was at highest risk for the onset and worsening of depressive symptoms. On the other hand, the type of treatment received does not appear to be a risk factor for depression.
Certain risk factors have been identified: Older women have an increased risk of depression, as do those with a high body mass index (overweight or obese) and those with a lower socio-economic level. Women with a history of psychiatric disorders, those already complaining of greater fatigue, suffering from anxiety problems, cognitive disorders or even having a poor body image of themselves at the time of diagnosis were also more likely to present depressive symptoms.
Psychological and physical consequences to better understand
Patients affected by depression also mentioned a greater impact of cancer on their lives: positive impact with more altruism, empathy towards others, greater health awareness; but also negative impact with more worry in general, particularly concerning employment and relationships with the partner.
During the treatment phase, most often associated with the onset of depressive disorder, a change in lifestyle, with weight gain, reduction in physical activity, increased alcohol consumption, was associated with symptoms. more serious depression.
These data make it possible to identify women most at risk from diagnosis to prevent depression using appropriate strategies. “Screening and monitoring of depressive symptoms is essential to intercept the psychological vulnerability of women diagnosed with breast cancer“, concludes Dr. Di Meglio. “Adapted psychological support as well as interventions aimed at reducing health risk behaviors such as weight gain, sedentary lifestyle and alcohol consumption, particularly during the treatment phase, could help reduce depressive symptoms in the long term after treatment. breast cancer“.