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. 2017 Aug 15;123(16):3107-3115.
doi: 10.1002/cncr.30688. Epub 2017 Apr 7.

Effect of depression before breast cancer diagnosis on mortality among postmenopausal women

Xiaoyun Liang  1 , Karen L Margolis  2 , Michael Hendryx  3 , Katherine Reeves  4 , Sylvia Wassertheil-Smoller  5 , Julie Weitlauf  6   7 , Suzanne C Danhauer  8 , Rowan T Chlebowski  9 , Bette Caan  10 , Lihong Qi  11 , Dorothy Lane  12 , Sayeh Lavasani  13 , Juhua Luo  14
Affiliations

Effect of depression before breast cancer diagnosis on mortality among postmenopausal women

Xiaoyun Liang et al. Cancer. .

Abstract

Background: Few previous studies investigating depression before the diagnosis of breast cancer and breast cancer-specific mortality have examined depression measured at more than 1 time point. This study investigated the effect of depression (combining depressive symptoms alone with antidepressant use) measured at 2 time points before the diagnosis of breast cancer on all-cause mortality and breast cancer-specific mortality among older postmenopausal women.

Methods: A large prospective cohort, the Women's Health Initiative, was used. The study included 3095 women with incident breast cancer who had measures of depressive symptoms and antidepressant use before their diagnosis at the baseline and at year 3. Multivariate Cox proportional hazards regression was used to estimate adjusted hazard ratios (HRs) between depression at the baseline, depression at year 3, and combinations of depression at these time points and all-cause mortality and breast cancer-specific mortality.

Results: Depression at year 3 before a breast cancer diagnosis was associated with higher all-cause mortality after adjustments for multiple covariates (HR, 1.35; 95% confidence interval [CI], 1.02-1.78). There was no statistically significant association of baseline depression and all-cause mortality or breast cancer-specific mortality whether or not depression was also present at year 3. In women with late-stage (regional- or distant-stage) breast cancer, newly developed depression at year 3 was significantly associated with both all-cause mortality (HR, 2.00; 95% CI, 1.13-3.56) and breast cancer-specific mortality (HR, 2.42; 95% CI, 1.24-4.70).

Conclusions: Women with newly developed depression before the diagnosis of breast cancer had a modestly but significantly increased risk for death from any cause and for death from breast cancer at a late stage. Cancer 2017;123:3107-15. © 2017 American Cancer Society.

Keywords: Cox proportional hazards regression model; breast cancer; depression; mortality; postmenopausal women.

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Conflict of interest statement

Conflict of interest: The authors do not have any conflicts of interest to report.

Figures

Figure 1
Figure 1. Flow diagram of participants included in the analysis
See this image and copyright information in PMC

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