Depression In Breast Cancer Patients Research Articles

Does virtual reality affect breast cancer patients' pain?: A literature review

Purpose: To comprehensively analyze scientific evidence regarding the effect of virtual reality on pain in breast cancer patients. Method: This is literature study using PubMed, ScienceDirect and Cochrane Library databases. The inclusion criteria in this literature review are articles published in the last 5 years (2020-2024), articles using Indonesian and English in journals of national or international reputation and research articles. The selected articles are articles that the author can download or open access. Result: Of the total 493 articles, there were 9 articles that were duplicates or the same article. After that, it was found that the titles of 457 articles did not match the topic. There were 14 articles that did not meet the inclusion criteria and 7 articles had inappropriate interventions and methodology. Finally, 5 articles were obtained that were suitable for analysis. Conclusion: The use of VR can effectively reduce levels of pain, anxiety, fatigue and depression in breast cancer patients, as well as improve their quality of life. These findings suggest that VR has the potential to be a valuable adjunct in the pain management of breast cancer patients.

Investigate Effects of Music Therapy on Functional Connectivity in Papez Circuit of Breast Cancer Patients Using fMRI.

The aim of this study is to investigate activity and functional connectivity (FC) of Papez circuit networks associated with music processing using functional magnetic resonance imaging (fMRI) in depressed breast cancer patients. Twenty-three breast cancer patients listened to four different Iranian/Persian music paradigms during the resting-state fMRI scanning session: negative stimulation of traditional music, negative stimulation of pop music, positive stimulation of traditional music and positive stimulation of pop music. The amplitude of low-frequency fluctuation (ALFF) was used to evaluate the local characteristics of spontaneous brain activity. FC maps were created using multivariate ROI-to-ROI connectivity (mRRC) and Papez circuit-based regions of interest (ROIs) selection. We found that music increases FC within various brain networks which are involved in memory, emotion, and cognitive function, including the limbic system, the default mode network (DMN), salience network (SN), and central executive network (CEN). Moreover, it seems that the traditional types (both positive and negative) of Iranian music may be more effective to affect brain activity in the patients with breast cancer, than the Iranian pop music. These findings demonstrate that music therapy, as an effective and easily applicable approach, supports the neuropsychological recovery and can contribute to standard treatment protocols in patients with breast cancer.

The impact of internet-based cognitive behavioral therapy on mental health outcomes and life in breast cancer patients: a systematic review and meta-analysis.

Internet-based cognitive behavioral therapy(ICBT) improves the impact of breast cancer through online platforms, modular learning, goal setting, relaxation exercises, and other techniques. Compared to traditional cognitive behavioral therapy (CBT), ICBT offers advantages such as the convenience of flexible time and location choices and reduced manpower requirements. In recent years, research exploring the impact of ICBT on breast cancer patients has been increasing, with conflicting results across different studies. Therefore, the purpose of this study was to comprehensively examine the impact of ICBT on the psychological health and quality of life of breast cancer patients through a systematic review and meta-analysis. We searched ten databases in both English and Chinese, with the search period extending from the inception of the databases to December 30, 2023. Literature screening, bias risk assessment, data extraction, and evidence level evaluation were independently conducted by two researchers. All the data were analyzed using RevMan 5.4 and Stata 17.0 software. A total of 2079 breast cancer patients were included in this study, of which 1171 patients received ICBT treatment. The results show that ICBT can reduce anxiety [SMD=-0.19, 95%CI (-0.37, -0.01), P=0.0008] and depression [SMD=-0.20, 95%CI (-0.37, -0.02), P=0.001], alleviate fatigue [SMD=-0.34, 95%CI (-0.67, -0.01), P=0.04], and improve quality of life [SMD=0.20, 95% CI (0.03, 0.38), P=0.02] in breast cancer patients. However, the intervention effects of ICBT on insomnia [SMD=-0.44, 95%CI (-0.93, 0.06), P=0.08] and sleep quality [SMD=-0.14, 95%CI (-0.30, 0.01), P=0.06] in breast cancer patients are not significant. The subgroup analysis showed that when the intervention period is longer than 8 weeks, the number of intervention modules exceeds 6, and a waitlist control group is included, there is a significant effect on reducing patients' anxiety and depression. However, the method of guidance and whether the intervention period exceeds 12 weeks are not related. ICBT can alleviate anxiety and depression in breast cancer patients, with the intervention effects being independent of the guidance method. Significant results were obtained when the intervention period was >8 weeks and the number of modules was >6. ICBT can reduce fatigue and improve quality of life in breast cancer patients, but its impact on sleep quality was not significant. More high-quality research is needed in the future. PROSPERO, identifier CRD42024494744.

EFFECTIVENESS OF COGNITIVE-BASED INTERVENTIONS FOR IMPROVING BODY IMAGE OF PATIENTS HAVING BREAST CANCER

Breast cancer is one of the most common tumors among women. CBT is an algorithmic, time-bound method of treatment that concentrates on altering negative cognitive processes and behavioral patterns. Objectives: The main objective of the study is to find the effectiveness of cognitive-based interventions for improving the body image of patients with breast cancer. Methods: This quasi-experimental study was conducted at Khyber Teaching Hospital Peshawar from January 2023 to January 2024. Data were collected from 105 breast cancer patients, all of whom had undergone various treatments such as mastectomy, lumpectomy, or chemotherapy, which resulted in noticeable physical changes. All patients diagnosed with breast cancer and having undergone surgical or medical treatments and experiencing concerns related to body image post-treatment with no prior history of psychiatric disorders were included in the study. Results: Data were collected from 105 patients. The results show that the intervention group experienced a significant improvement in body image, with a 45.6% reduction in Body Image Scale (BIS) scores from 22.8 ± 3.5 pre-intervention to 12.4 ± 3.1 post-intervention (p = 0.001). In contrast, the control group showed only a minimal 3.6% improvement, with scores decreasing slightly from 22.5 ± 3.7 to 21.7 ± 3.4 (p = 0.152). Conclusion: It is concluded that cognitive-based interventions, particularly Cognitive Behavioral Therapy (CBT), are highly effective in improving body image and reducing anxiety and depression in breast cancer patients.

The Effect of Cosmetic Makeup on Body Imagery and Anxiety and Depression in Patients Undergoing Postoperative Chemotherapy for Breast Cancer: A Randomized Controlled Study.

Purpose: The objective was to compare the body images of breast cancer patients undergoing postoperative chemotherapy and the varying degrees of their anxiety and depression. The comparison involved those who received four consecutive cycles of cosmetic makeup and those who did not. Patients and Methods: Seventy-four breast cancer patients receiving postoperative chemotherapy were randomly assigned to either the control group or the intervention group. The control group received usual care, while the intervention group received four consecutive cycles of chemotherapy along with cosmetic makeup intervention on top of usual care. The intervention was carried out on the first day after the completion of each chemotherapy cycle. Assessments were made before the first intervention and 1 month after the fourth intervention using the Hospital Anxiety and Depression Scale and the Scale of Body Imagery. Results: After four cycles of intervention, significant differences emerged between the intervention and control groups regarding anxiety, depression, and body imagery. Additionally, within the intervention group, notable changes in these aspects were observed over time. Conclusion: The results showed that cosmetic interventions can effectively reduce the level of anxiety and depression of breast cancer patients receiving postoperative chemotherapy and effectively improve the body imagery of patients.

CORRELATION OF CHEMOTHERAPY CYCLES WITH STAGE OF DEPRESSION IN BREAST CANCER PATIENTS

Breast cancer is the most common cancer in women around the world, including Indonesia. Women with breast cancer are more vulnerable to psychological symptoms compared to the general population before or after treatment. Psycological symptoms such as depression, anxiety, and fatigue correlate with increasing pro-inflammatory mediators as the response to the malignancy process and also anti-cancer treatment. The psychological symptoms have a bad impact on cognitive functions and lower the quality of life of cancer patients. The research aims to determine the depression prevalence and chemotherapy cycle correlation with the severity of depression in breast cancer patients at Rumah Sakit Umum Cut Meutia, Aceh Utara Regency. This study is an analytical observational study with a cross-sectional approach. The study sample of 66 breast cancer patients undergoing chemotherapy at the Rumah Sakit Umum Cut Meutia, Aceh Utara was obtained using the consecutive sampling method in accordance with the established inclusion and exclusion criteria. The chemotherapy cycle is known from medical records and depression score assessments referring to the Depression Anxiety Stress Scales questionnaire (DASS 42). The correlation of chemotherapy cycles with depression scores was analyzed using the Spearman correlation test. The results showed that the characteristics of the sample were mostly aged 46–55 years, already in stage IV, undergoing cycle 2 or 3 chemotherapy, using an antracylin-based regimen, and not yet depressed (normal). Correlation analysis showed a positive correlation (p 0.001) of moderate degree (r = 0.42) between chemotherapy cycles and degrees of depression. It can be concluded that increasing chemotherapy cycles tends to increase the severity of depression.

Effect of music therapy on anxiety and depression in breast cancer patients: systematic review and meta-analysis

To systematically evaluate the intervention effect of music therapy on anxiety and depression in breast cancer patients. Randomised controlled trial (RCT) on music therapy for anxiety and depression in breast cancer patients was searched from 7 major databases, PubMed, Embase, the Cochrane Library, WOS, CNIC, Wanfang, and Wipro, spanning the period of library construction to 23 October 2023, and the literature screening of music therapy for anxiety or depression in breast cancer patients was carried out by 2 experimentalists, each of whom conducted a literature screening RCT independently of the other anxiety or depression in a RCT. Methodological quality was evaluated using the PEDro scale; GRADE profiler software for quality of evidence; and RevMan 5.4 was used for effect size merging and forest plots; publication bias tests and sensitivity analyses were performed using Stata 17.0; and standardized mean difference (SMD) and 95% CI were used as the effect statistics. A total of 13 RCTs with 1326 subjects (aged 18–70 years) were included in the literature, with a mean PEDro score of 6.8, and the literature was overall of good methodological quality. Meta-analysis showed that music therapy improved anxiety in breast cancer patients (841 cases), with a combined effect size (SMD = − 0.82, 95% CI [− 1.03, − 0.61] and P < 0.001); and improved depression in breast cancer patients (387 cases) with a combined effect size (SMD = − 0.76, 95% CI [− 1.15, − 0.38], P < 0.001). Subgroup analyses showed that music intervention with off-site music (757 cases) and music choice of non-self-selected music (537 cases) had the best effect on anxiety improvement, with corresponding combined effect sizes (SMD = − 0.88, P < 0.001; SMD = − 0.83, P < 0.001), respectively; followed by an intervention length of < 30 min (589 cases), a frequency of 2 times/day (382 cases), and intervention period of 2–3 weeks (101 cases) had the best effect on anxiety improvement, and the corresponding combined effect sizes were (SMD = − 0.80, P < 0.001; SMD = − 0.91, P < 0.001; SMD = − 1.02, P < 0.001), respectively; and the music selection was the choice of one's own favourite music among the expert recommendations (219 cases) (270 cases) had the best effect on the improvement of depressed mood, with combined effect sizes of (SMD = − 1.15, P < 0.001; SMD = − 0.71, P < 0.001) and music with an intervention duration of 30 min (287 cases), an intervention frequency of 1 time/day (348 cases), and an intervention period of 2–4 weeks (120 cases), respectively, with corresponding combined effect sizes of (SMD = − 0.75, P < 0.001; SMD = − 0.86, P < 0.001; SMD = − 1.06, P < 0.001), respectively. Music therapy can improve anxiety and depression in breast cancer patients, and the level of evidence is moderate. Although the heterogeneity between studies is high, which may lead to bias in the results, we explored the source of heterogeneity through subgroup and sensitivity analyses, providing a good evidence-based basis for clinical practice. The heterogeneity of anxiety and depression was explored by subgroup analysis, with anxiety due to music duration and music cycle; and depression due to intervention cycles and music duration. Sensitivity analyses also identified music duration and music cycle as contributing to the heterogeneity. Also, this study has some limitations since the included literature did not take into account the duration of the disease, education, and family economic status and did not categorize the age stages. This study found that music therapy improves anxiety and depression in breast cancer patients and the results can be used as a basis for clinical practice and researcher enquiry. This research has been registered on the INPLASY platform (https://inplasy.com/contact/) under the number: INPLASY2023100057.

Psychometric Properties of the Patient Health Questionnaire-9 in Patients With Breast Cancer.

Due to the high frequency of depressive symptoms associated with breast cancer, it is crucial to screen for depression in breast cancer patients. While numerous screening tools are available for depression in this population, there is a need for a brief and convenient tool to enhance clinical use. This study aims to investigate the psychometric properties of the Patient Health Questionnaire-9 (PHQ-9) in patients with breast cancer. Patients with breast cancer (n=327) who visited the Breast Cancer Clinic were included in this study. The reliability of the PHQ-9 was analyzed by Cronbach's α, and the construct validity of the PHQ-9 was explored by factor analysis. The concurrent validity of the PHQ-9 was evaluated by Pearson correlation analysis with the Hospital Anxiety and Depression Scale (HADS) and Perceived Stress Scale (PSS). The values of Cronbach's α ranged from 0.800 to 0.879 was acceptable. The exploratory factor analysis revealed that the one-factor model and two-factor model of the PHQ-9 explained 46% and 57% of the variance, respectively. The PHQ-9 were significantly correlated with those of HADS (r=0.702, p<0.001) and PSS (r=0.466, p<0.001). Consequently, the PHQ-9 demonstrated acceptable reliability and validity in breast cancer patients. The findings of this study indicate that the PHQ-9 exhibits acceptable reliability and validity in patients with breast cancer. The convenience of this brief self-report questionnaire suggests its potential as a reliable and valid tool for assessing depression in breast cancer clinics.

Evolution of Depression and Anxiety among Breast Cancer Patients: a prospective analysis using clinical, biological and genetic factors

IntroductionNumerous studies have explored the symptoms and course of depression and anxiety in breast cancer patients and identified various clinical, sociodemographic, and genetic factors associated with their evolution. Nevertheless, these studies have been limited in duration and have focused on specific time points during chemotherapy or post-treatment follow-up. Furthermore, these studies included patients receiving different treatment regimens and used different tools to assess symptoms.Objectives To assess the prospective evolution of depression in breast cancer patients over eight consecutive chemotherapy cycles, taking into account sociodemographic, clinical, biological, and genetic factors.MethodsA prospective longitudinal study was conducted on 69 breast cancer patients treated with intravenous chemotherapy at the oncology outpatient unit of the Hôtel-Dieu de France hospital (2017-2019; Ethics: CEHDF1016). The Hospital Anxiety and Depression Scale (HADS) was used to evaluate anxiety and depression in patients. Genotyping was performed for several genes (ABCB1, COMT, DRD2, OPRM1, CLOCK, CRY2, PER2) using the Lightcycler® 2.0 (Roche).ResultsUnivariate repeated measures analysis showed differences in the evolution of depression and anxiety over time. For depression, a polynomial linear contrast for HADS-D scores was noted from cycle 1 to cycle 8, with a significant increase in depression at cycles 7 and 8 compared with cycle 1 (p-value cycle7=0.004 and p-valuecycle8=0.009; Figures 1 &amp; 2). Repeated measures analysis for anxiety showed a decrease in anxiety scores between cycles 1 and 6 of chemotherapy, followed by an increase starting cycle 6 (a polynomial trend for contrasts) (p-value cycle6 versus 1=0.038; Figures 1 &amp; 2). Multivariable analysis showed that higher anxiety and depression scores at baseline were both associated with higher depression and anxiety scores over time. Other clinical and genetic factors, including polymorphisms in the OPRM1, PER2, and COMT genes, were also significantly associated with higher depression and anxiety scores.Image:Image 2:ConclusionsOur findings highlight the importance of understanding the trajectories of depression and anxiety over time in women with breast cancer and identifying the triggering factors. Such personalized approaches would improve patient quality of life.Disclosure of InterestNone Declared

Prevalence of depressive disorders in breast cancer patients

IntroductionBreast cancer is the most common type of cancer and the leading cause of death from malignant neoplasms in women in Russia and in most countries in the world (Lima et al. EClinicalMedicine 2021; 38 100985). According to an analysis of the incidence and mortality from 36 cancers in 185 countries (Sung et al. CA Cancer J Clin 2021. 3 209-249) in 2020, 2261419 new cases of breast cancer were identified in the world in both sexes, which is accounted for 11.7% of the total cancer incidence. Mortality from breast cancer in 2020 amounted to 684996 cases. Patients with comorbid depression and anxiety disorders experience more severe symptoms, have longer recovery time, use more healthcare resources and have poorer outcome compare to those with cancer alone (Katon et al. Gen Hosp Psychiatry 2007; 2 147-155).ObjectivesAnalytical review of data on the impact of depressive spectrum disorders as comorbid conditions on the survival of breast cancer patients and their quality of life.MethodsThe following databases were searched for publications: PubMed, Embase, CINAHL, PsycINFO, Scopus, Science Citation Index/Social Sciences Citation Index, Cochrane Evidence Based Medicine database. The searches were limited to English language and studies with more than 100 subjects with diagnosed breast cancer where this information was mentioned. The analyzed period is between 1977 and 2018.ResultsThe reported prevalence of depression in breast cancer patients, according to researches, varies 4,5 to 38%. In patients with I-III stage breast cancer depression increased hazards of all-cause mortality by 50% compared to non-depressed patients. Stage-specific analyses demonstrated a 2–2.5 fold increase in breast cancer-specific and all-cause mortality in patients with stage I and II disease (Vodermaier et al. Breast Cancer Res Treat 2014; 2 373-384.). Women with non-metastatic breast cancer who report mild to moderate depressive symptoms in the weeks after surgery have approximately 2.5 times greater risk of death 8–15 years later than women who report little or no depressive symptoms post-surgery (Antoni et al. Gen Hosp Psychiatry 2017; 44 16-21). Depression in advanced cancer not only reduces quality of life but is also an independent predictor of poorer survival (Lloyd-Williams et al. J Affect Disord 2009; 113 127-132.).ConclusionsDepression and anxiety both have adverse effects on recurrence and all-cause mortality in patients with breast cancer. Untreated depression leads to significant increase in incidence and mortality. Depression can debut at any stage of cancer, including the stage of diagnosis. It proves the necessity for affective disorders screening in patients with cancer on the stage of diagnosis. Patients with diagnosed affective disorders should be observed not only by oncologist, but also by a psychotherapist in order to receive the necessary treatment to improve the quality of life and reduce the risk of mortality.Disclosure of InterestNone Declared

The Effect of Concomitant Conservative Breast Surgery with Reconstruction on Quality of Life of and Depression in Breast Cancer Patients

The Effect of Concomitant Conservative Breast Surgery with Reconstruction on Quality of Life of and Depression in Breast Cancer Patients

Factors Affecting Fatigue in Breast Cancer Patients Undergoing Radiotherapy

Purpose: The aim of this study was to investigate the effects of nutrition risk, physical activity, insomnia, anxiety, and depression on fatigue among breast cancer patients undergoing radiotherapy.Methods: The participants of this study were 160 breast cancer patients at Yeungnam University Medical Center in South Korea. The data were collected from September to November 2022 and analyzed using descriptive statistics, the t-test, analysis of variance, the Mann-Whitney test, the Kruskal-Wallis test, the Bonferroni correction, Pearson correlation coefficients, and multiple regression with SPSS version 28.0.Results: The mean fatigue score was 18.44±7.30 points, while the scores for nutrition risk, insomnia, anxiety, and depression were 2.03±1.52, 5.43±4.79, 6.79±2.81, and 8.17±3.36 points, respectively. Physical activity was measured at 1366.49±1617.87 METs. The general characteristics of the participants showed significant differences in fatigue concerning pain (F=13.97, &lt;i&gt;p&lt;/i&gt;=.001), duration of illness (t=-2.37, &lt;i&gt;p&lt;/i&gt;=.019), and total radiation dose (t=-2.13, &lt;i&gt;p&lt;/i&gt;=.035). Fatigue exhibited significant positive correlations with nutrition risk (r=.35, &lt;i&gt;p&lt;/i&gt;&lt;.001), insomnia (r=.35, &lt;i&gt;p&lt;/i&gt;&lt;.001), and anxiety (r=.35, &lt;i&gt;p&lt;/i&gt;&lt;.001), and a significant negative correlation with physical activity (r=-.20, &lt;i&gt;p&lt;/i&gt;=.012). In multiple regression analysis, the factors influencing fatigue were identified as nutrition risk (β=.28, &lt;i&gt;p&lt;/i&gt;&lt;.001), duration of illness (β=.19, &lt;i&gt;p&lt;/i&gt;=.005), depression (β=.23, &lt;i&gt;p&lt;/i&gt;=.006), total radiation dose (β=.19, &lt;i&gt;p&lt;/i&gt;=.005), and physical activity (β=-.14, &lt;i&gt;p&lt;/i&gt;=.036).Conclusion: This study highlights the importance of addressing nutrition risk and depression in breast cancer patients undergoing radiotherapy. Encouraging physical activity may also play a crucial role in managing fatigue in these patients. These findings could guide the development of targeted interventions to improve the well-being of breast cancer patients during radiotherapy.

Anxiety, Stress and Depression in Breast Cancer Patients Undergoing Chemotherapy; a Cross-Sectional Study

Anxiety, Stress and Depression in Breast Cancer Patients Undergoing Chemotherapy; a Cross-Sectional Study

Depression and Breast Cancer in Morocco: Prevalence and Associated Factors.

Depression is frequently associated with breast cancer. However, its prevalence and impact on patients' quality of life are negligible. Depression is often underdiagnosed and less treated. Our study is aimed at estimating the prevalence of depression in breast cancer patients, describing their sociodemographic and clinical profile, and determining the factors associated with this depression. Material and Methods. We carried out a cross-sectional, descriptive, and analytical study, conducted from January to March 2018 at Mohammed V Military Hospital in Rabat. The survey included 100 breast cancer patients. It was conducted using an anonymous questionnaire, the Mini International Neuropsychiatric Interview test (MINI test) to diagnose depression and the Beck Depression Inventory (BDI) to assess its severity. The major depressive episode was diagnosed in 26% of breast cancer patients. Age under 40, psychiatric history, metastatic breast cancer, refusal of treatment, heavier treatment, and spousal alteration were the factors most associated with higher depression prevalence in these patients. Discussion and Conclusion. The high prevalence of depression in breast cancer patients, as well as the influence of personal characteristics and treatment in the occurrence of this ailment, has been confirmed by several authors. It is recommended to improve the psychooncological care of patients with breast cancer, to prevent the occurrence of depression in this vulnerable population.

The Prevalence of Anxiety and Depression in Breast Cancer Patients and their Correlation with Socio-Demographic Factors

Introduction: Being diagnosed with breast cancer or receiving surgery, radiation or chemotherapy as a treatment modality in itself is seen as a traumatic experience for many women. This emotional distress is in turn associated with reduced quality of life and can pose a negative influence on compliance with treatment. Ultimately leading to an elevated risk of mortality which is also seen as the sixth vital sign in cancer care.Aim &amp; Objectives: The purpose of our study is to estimate the prevalence of depression and anxiety in breast cancer patients and their correlation with socio-demographic factors. Materials and Methods: A cohort of 140 breast cancer patients registered in the Department of Radiation Oncology, SMS medical College, Jaipur from January 2022 to December 2022 were recruited and interviewed with a structured questionnaire including socio-clinical and demographic factors and PHQ-2 and GAD-2 scales. Results: Prevalence of depression among patients were 37.9% (53/140) and almost one third (33.6%, 47/140) of cases had anxiety. Around two thirds (69.3%, 97/140) cases had stage III breast cancer, followed by stage II in 23 (16.4%) cases and 20 (14.3%) cases had IV stage breast cancer. The place of residence, educational status, employment status, accompanying person and marital status emerged as significant predictors of depression risk, while age group, marital status and financial status were found to have statistically significant association with elevated anxiety symptoms.Conclusion: This study shows that prevalence of anxiety and depression in breast cancer patients is high and patients from rural areas, single, low monthly income, younger age group and low education level were more prone. Therefore, special care and support and often referral to psychiatry department may be required in such group of patients.

Integrative dissection of 5-hydroxytryptamine receptors-related signature in the prognosis and immune microenvironment of breast cancer.

Depression increases the risk of breast cancer recurrence and metastasis. However, there lacks potential biomarkers for predicting prognosis in breast cancer. 5-hydroxytryptamine (5-HT) plays a key role in the pathogenesis and treatment of depression. In this study, we developed a prognostic signature based on 5-HT receptors (5-HTRs) and elucidated its potential immune regulatory mechanisms for breast cancer prognosis. Oncomine, GEPIA, UALCAN, cBioPortal, Kaplan-Meier plotter, and TIMER were used to analyze differential expression, prognostic value, genetic alteration, and immune cell infiltration of HTRs in breast cancer patients. The model training and validation assays were based on the analyses of GSE1456 and GSE86166. A risk signature was established by univariate and multivariate Cox regression analyses. The transwell assay was utilized to verify the effect of the 5-HTRs expression on breast cancer invasion. Effects of HTR2A/2B inhibitor on CD8+ T cell proliferation and infiltration as well as apoptosis of 4T1 cells in the tumor microenvironment were detected by flow cytometry and TUNEL assay. Zebrafish and mouse breast cancer xenografts were used to determine the effect of HTR2A/2B inhibitor on breast cancer metastasis. The expression levels of HTR1A, HTR1B, HTR2A, HTR2B, HTR2C, HTR4, and HTR7 were significantly downregulated in highly malignant breast cancer types. 5-HTRs were significantly associated with recurrence-free survival (RFS) in breast cancer patients. The genetic alteration of HTR1D, HTR3A, HTR3B, and HTR6 in breast cancer patients was significantly associated with shorter overall survival (OS). Finally, HTR2A and HTR2B were determined to construct the risk signature. The expression of HTR2A/2B was positively correlated with the infiltration of immune cells such as CD8+ T cells and macrophages. Furthermore, inhibition of HTR2A expression could suppress CD8+ T cell proliferation and enhance invasion and metastasis of breast cancer cells in both zebrafish and mice model. The HTR2A/2B risk signature not only highlights the significance of HTRs in breast cancer prognosis by modulating cancer immune microenvironment, but also provides a novel gene-testing tool for early prevention of depression in breast cancer patients and lead to an improved prognosis and quality of life.

Global depression in breast cancer patients: Systematic review and meta-analysis.

Breast cancer is known as one of the most common diseases among women, the psychological consequences of which are common in women and affect various aspects of their lives, so this study aims to investigate the prevalence of depression among women with breast cancer globally. The present meta-analysis was performed by searching for keywords related to breast cancer and depression in 4 main databases: PubMed, Embase, Web of Sciences and Scopus in the period of January 2000 to November 2021 and the results of the study using R and CMA software were analyzed. A total of 71 studies were selected in English and the results of the analysis showed that the prevalence of depression in women with breast cancer is 30.2%, with Pakistan having the highest (83%) prevalence of depression and Taiwan having the lowest (8.3%). And in the WHO regions, EMRO region had the highest (49.7%) rate and SEARO region had the lowest (23%) prevalence of depression. Also, with increasing age, the prevalence of depression among women with breast cancer increases. Community and family support for women with breast cancer, holding psychology and psychotherapy courses, lifestyle modifications and training in this area can be effective in preventing the reduction of the prevalence of depression, and given the pivotal role of women in family affairs, this This can be in line with the work of health system policymakers.

Research on the applicability of an exercise rehabilitation app aiming to improve the mental and physical health of breast cancer patients in the post-operative period.

Breast cancer is one of the most common malignant cancers in women, seriously endangering the physical and mental health of patients. In this study, we developed an app for breast cancer patients undergoing radiotherapy or chemotherapy with a focus on exercise interventions, supplemented by nutritional and psychological interventions, to verify the applicability of the app for these patients and its impact on their quality of life, sleep, and psychological state. We also investigated the patients' experience and perceptions of the app. A total of 17 participants, aged 42-58 years, were recruited for this study using a mixed-methods design, including quantitative group pre-and post-test scores and qualitative interview results. The participants used the app for 8-18 weeks depending on their radiotherapy or chemotherapy cycle. During the radiotherapy or chemotherapy period, the participants used the "Yun Dong Ru Kang" exercise rehabilitation app to perform aerobic exercises twice a week, as well as rehabilitation exercises appropriate to their radiotherapy or chemotherapy stage, and used the app on their own the rest of the time. The primary results included their scores on the PSSUQ overall assessment usability questionnaire, the users' use of the app, and the results of the interviews; the secondary indicators were quality of life, sleep status, and anxiety and depression status. An overall score of 6.2 (out of 7 points) on the PSSUQ questionnaire indicates the high usability; the average use time per subject per week was 97.69 ± 11.82 min, which exceeds the minimum use time, but the average use time tended to decrease as the use time was postponed. Promoted articles on nutritional diets received the most hits. The results of the interviews were consistent with the questionnaire scores, with the majority of participants believing that the means of exercise should be enriched and the interface optimized, while the reduction in the length of use was related to the participants' own state of learning about calisthenics. In the results of the Breast Cancer-Specific Scale FACT-B, there was a significant increase (p < 0.05) in the Emotional Status dimension score and a significant decrease (p < 0.05) on the Additional Concerns dimension score. In the results of the Pittsburgh Sleep Quality Inventory PSQI, there was a non-significant improvement in all items except for a significant increase (p < 0.05) for the Hypnotic Medication item. In the Hospital Anxiety and Depression Scale (HADS), there was no significant improvement in any of the anxiety and depression factors. The "Yun Dong Ru Kang "app has certain applicability, and the use of the exercise rehabilitation app may effectively reduce the negative impact of chemotherapy side effects on the quality of life, sleep and depression of breast cancer patients in the chemotherapy or radiotherapy phase. Before it is put into use in the future, the app should be enriched with exercise tools, the interface should be optimized, and articles on nutrition and diet should be promoted.

DEPRESSIONAND RELATED FACTORS AMONG MOROCCAN BREAST CANCER PATIENTS: RESULTS OF ACROSS-SECTIONAL STUDY

Introduction: Depression is frequently associated with breast cancer. Although its prevalence and its impact on patientsquality of life are far from negligible, depression is often under-diagnosed and less treated. Objectives: Our study aims to estimate the prevalence of depression in breast cancer patients, to describe their socio-demographic and clinical profile, and to determine the factors associated with this depression. Material and Methods: We carried out a cross-sectional, descriptive and analytical study, conducted from October to December 2021 at the Mohammed IV Cancer Treatment Center. The survey included 100 breast cancer patients. It was conducted using an anonymous questionnaire and the Beck scale to diagnose depression and to assess its severity. Results: Depression in a major form was diagnosed in 52% of breast cancer patients. Age under 40, psychiatric antecedents, metastatic breast cancer, refusal of treatment, heavy treatment regimens and the alteration of the conjugal relationshipwere the factors most associated with higher prevalence of depression in these patients. In the light of what has been demonstrated in the analytical study, we note that the occurrence of a major depressive episode is significantly correlated with the following parameters - Age ranging between 20 and 40 years. - Metastatic spread of breast cancer. - Negative attitude of the spouse. - Relapse of the cancerous disease. Discussion and Conclusion: The high prevalence of depression in breast cancer patients as well as the influence of personal characteristics and treatment in the occurrence of this ailment have been confirmed by several authors. We propose some suggestions to improve the psycho-oncological care of patients with breast cancer, in order to prevent the occurrence of depression in this population.

Pretreatment Depressive Status Associated with Poor Nutrition and Prognosis in Breast Cancer Patients Receiving Neoadjuvant Chemotherapy

The prevalence of pretreatment depression in breast cancer patients and its impact on nutrition and prognosis during neoadjuvant chemotherapy remain unknown. One hundred twenty-one patients with previously untreated breast cancer undergoing neoadjuvant chemotherapy (NAC) were enrolled. Patients completed the Self-rating Depressive symptoms Scale (SDS) before treatment and were divided into two groups (non-depressive group and depressive group). The nutrition risk screening-2002 (NRS-2002), and nutritional and prognostic indicators, including neutrophil-to-lymphocyte ratio (NLR) and prognostic nutritional index (PNI), were collected at baseline (pretreatment) and post-treatment. One- and two-year progression-free survival (PFS) in both groups were also calculated. We found that 38.84% patients experienced pretreatment depressive symptoms. Patients in the depressive group had higher nutritional risk and lower body mass index, potassium, sodium, total cholesterol, total protein, and fasting blood glucose levels than those in pretreatment non-depressive group after NAC (all p < 0.05). And higher NLR (p = 0.039) and lower PNI level (p = 0.0021) after NAC were found in patients with pretreatment depressive status. Multivariable Cox analysis showed pretreatment depressive status (HR: 1.893; 95% CI: 1.047-3.426; p = 0.034) were a significant predictor of PFS. This study provides evidence for early identification of pretreatment depression in patients receiving NAC, which would certainly favor nutrition and survival outcome.