Quality of life, depressed mood, and anxiety in women presenting with locally advanced breast cancer

Abstract

8249 Background: Despite advances in breast cancer screening, the rate of women presenting with locally advanced breast cancer (LABC) has remained unchanged for the past 10 years. These women are at greater risk of dying from their disease. We hypothesize that psychosocial factors (e.g., depression and anxiety) may have an impact on their quality of life over and above the effects of treatment. Methods: We completed one-on-one interviews with clinical stage II or III breast cancer patients prior to start of breast cancer treatment. Quality of life (QOL) using the FACT-B as well as demographic variables and symptoms of depressed mood and anxiety using the Center for Epidemiologic Studies Depression Scale and Beck Anxiety Inventory, respectively, were assessed. Results: With a targeted accrual of 40 patients in the first year (120 over 3 years), 34 have been enrolled in 10 months. The sample is 70.6% white (2.9% Hispanic), 23.5% African American, 5.9% Asian Indian or Pakistani, 70.6% married, 58.8% employed at least part time, 50% with more than high school education, and mean age of 52 years (range 38–68). On average, patients reported moderately high levels of QOL (mean +/- SD 109.8 +/-18.8; possible high score=144), little or no depressed mood (11.7 +/- 9.1; possible high score=60), and mild-moderate anxiety (10.9 +/- 6.6; possible high score=63). However, 35% reported levels of depressed mood higher than 16, a cut-off score consistent with that of clinically depressed patients, and 59% reported at least mild-moderate anxiety (scores 10–18, with non-clinical samples reporting <10). Depressed mood and anxiety were correlated with QOL (each p < 0.001). Conclusions: One-third of newly diagnosed LABC patients reported symptom scores consistent with clinical depression, and over half reported mild-moderate anxiety -each higher than levels found in non-clinical populations. In addition to being correlated with QOL, anxiety and depression might contribute to delay in diagnosis as well as affect treatment compliance. Thus, psychosocial adjustment of women with LABC should and will be monitored throughout their breast cancer treatment. Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Novartis; Pfizer