Abstract

ObjectiveThe objective of this study was to compare the incidence of post-operative depression in breast cancer patients who have undergone mastectomy with the incidence of post-operative depression in non-breast cancer participants (controls).MethodsUsing data from the Korean Health Insurance Review and Assessment Service (HIRA), we selected 2,130 patients with breast cancer who have undergone mastectomy for this national cohort study and matched these patients 1:4 with 8,520 control participants according to age, sex, income, region, and pre-operative depression. The incidence of post-operative depression was measured from mastectomy year to post-op year 10. The Mann-Whitney U test was used for data analysis, and the false-discovery rate was applied to determine statistical significance (P < 0.05).ResultsThe incidence of depression was higher in the breast cancer with mastectomy group than in the control group up to 3 years after mastectomy). However, there was no difference in the incidence of depression between the breast cancer with mastectomy group and the control group after post-op 4 years. The incidence of depression was higher in the breast cancer with mastectomy group than in the control group up to 2 years after mastectomy, and there was no difference in the incidence of depression between the two groups after post-op 3 years in middle-aged and older adults (≥ 40 years old). In young adults (≤ 39 years old), the incidence of depression was significantly higher in the breast cancer with mastectomy group than in the control group in mastectomy year.ConclusionPatients undergoing mastectomy for breast cancer experience depression more frequently than healthy people. However, patients overcome their depressive mood symptoms during the postoperative period. Young adults overcome their symptoms more quickly than middle-aged and older adults.

Highlights

  • Breast cancer is the most common invasive cancer in women worldwide, affecting approximately 12% of women [1]

  • The incidence of depression was higher in the breast cancer with mastectomy group than in the control group up to 3 years after mastectomy)

  • There was no difference in the incidence of depression between the breast cancer with mastectomy group and the control group after post-op 4 years

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Summary

Introduction

Breast cancer is the most common invasive cancer in women worldwide, affecting approximately 12% of women [1]. A Korean study reported that breast cancer accounted for 14.8% of all female cancers in 2012 [3]. The 5-year-survival rate for breast cancer has improved due to earlier tumor detection and improvements in treatment. These developments have resulted in increasing numbers of women surviving breast cancer [4]. These women experience a wide range of functional and emotional impairments, such as depression, after mastectomy, and these impairments have profound psychosocial effects. Mood disorder diagnosis failure can be problematic because depression and its associated symptoms diminish quality of life and affect compliance with medical therapies and may reduce survival [10]

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