Predictors of depressive symptoms 12 months after surgical treatment of early-stage breast cancer.

OBJECTIVE: Nearly half of the women with breast cancer (BC) show depressive symptoms in the first year after diagnosis. This has a major impact on patients' lives. Therefore, the aim of this study was to identify predictors of depressive symptoms 12 months after surgical treatment. Furthermore, the stability of depressive symptoms across 12 months was investigated for persons scoring high versus low/moderately on agreeableness, trait anxiety, and neuroticism.
METHODS: From the 609 women with an abnormality in the breast, 223 appeared to have early-stage BC. A depressive symptoms questionnaire (Center for Epidemiological Studies-Depression Scale) was completed before diagnosis and 1, 3, 6, and 12 months after surgical treatment. In addition, patients completed questionnaires on personality (State Trait Anxiety Inventory, Neuroticism-Extraversion-Openness-Five Factor Inventory), fatigue (Fatigue Assessment Scale), and aspects of quality of life (World Health Organization Quality of Life assessment instrument-100).
RESULTS: Before diagnosis and 1 year later, 40.9% and 27.8% of the women, respectively, scored above the established cut-off score for depressive symptoms. Depressive symptoms significantly improved in this period. Patients reported higher scores, when they had a breast-conserving therapy (BCT), scored low on agreeableness, scored high on neuroticism, or reported higher scores on depressive symptoms or fatigue before diagnosis. Other clinical and socio-demographic factors did not predict depressive symptoms.
CONCLUSIONS: Besides BCT, fatigue, and depressive symptoms, personality, especially neuroticism and agreeableness, predicted depressive symptoms 1 year after surgical treatment. Therefore, it is important to screen patients on these characteristics in order to prevent long-term depressive symptoms.