Importance of surgical role on anxiety of patients with breast cancer: Twelve-month follow-up prospective study.

Abstract

195 Background: Breast cancer diagnosis and treatment often produce stress in patients.Anxiety is one of the most prevalent psychological symptoms perceived by breast cancer patients. This study aims to evaluate the temporal patterns of anxiety and find factors associated with persistent anxiety during breast cancer treatment. Methods: This is prospective cohort study. Between July 2010 and July 2011, we recruited patients with non-metastatic breast cancer who were expected to receive adjuvant chemotherapy (N = 411) from two cancer hospitals in Seoul, Korea. Trained researchers interviewed participants and the patients also completed questionnaires on quality of life at enrollment (before surgery), 2 weeks, 3 months, 6 months and 12 months post-surgery. Anxiety was measured using the Hospital Anxiety and Depression Scale (HADS). Borderline and abnormal levels of HADS scores were classified into the abnormal group for comparison purposes. Results: The mean age of the participants was 46.4 (±7.9) years. Preoperatively, 44.5 % (183/411) of the patients showed abnormal anxiety. The proportion of the subnormal anxiety group significantly decreased after surgery (P < .01) and this phenomenon continued until the 12 month follow-up point. Patients experienced renewed anxiety at 12 months when the main adjuvant therapies were finished. Socioeconomic factors were not associated with persistent anxiety. Pain, breast, and arm symptoms were significantly higher in the persistently abnormal group, especially at postoperative 6months and 12months. Conclusions: Anxiety disorder was common in patients who were diagnosed with breast cancer (44.5%). Surgery was a major relieving factor of anxiety, and patients who finished their main adjuvant treatment experienced renewed anxiety. Surgeons should be the main detectors and care-givers with respect to psychological distress in breast cancer patients. To reduce persistent anxiety, caring for the patient’s physical symptoms is important.