A single centre study investigating the risk of recurrence for adjuvant hormone receptor positive breast cancer patients with mental health conditions.

Abstract

e12552 Background: Mental health conditions are associated with poorer health outcomes. Much of the focus in the association between adjuvant breast cancer outcomes and mental health have focussed on the interaction between specific antidepressants and tamoxifen. The influence of mental health conditions overall and breast cancer outcome have been less well studied. Methods: This was a single centre retrospective study of data from 1921 women treated with curative intent for hormone receptor positive breast cancer. Demographic data was obtained on this cohort from case notes, as well as treatment and outcome details. Patients were identified as having a mental health condition based on case notes and medication charts. For the purpose of analysis only those on medication for a mental health condition at time of diagnosis of breast cancer were included in this study. Medications included both antipsychotics and antidepressant medications. Cox univariate and multivariate analysis was undertaken. Results: Of the 1921 patients in this cohort, 251 (13.1%) were on medication for mental health condition at the time of diagnosis of breast cancer. On univariate Cox regression analysis, those with a mental health condition were at increased risk of disease recurrence, with a hazard ratio 1.49 (95% CI 1.08 to 2.07, p = 0.016) and, on adjusted analysis the risk of recurrence for those with a mental health condition had a risk of recurrence more than double that of those without a mental health condition (HR 2.59, 95% CI 1.65-4.08, p < 0.001). Conclusions: Risk of recurrence was significantly higher for patients with mental health conditions treated with curative intent. Further research is required to identify the mechanisms underlying this poorer outcome. Such research can then be utilised to guide interventions to reduce the risk of recurrence for this group.