Post-surgical depressive symptoms and long-term survival in non-metastatic breast cancer patients at 11-year follow-up

Michael H. Antoni, Jamie M. Jacobs, Laura C. Bouchard, Suzanne C. Lechner, Devika R. Jutagir, Lisa M. Gudenkauf, Bonnie B. Blomberg, Stefan Glück, Charles S. Carver

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Background Mild to moderate depressive symptoms are common during treatment for non-metastatic breast cancer. The goal of this secondary analysis was to determine if depressive symptoms predict clinical outcomes at long-term follow-up. Methods From 1998 to 2005, we interviewed 231 women with the Hamilton Rating Scale for Depression who were participating in a psychosocial study 2–10 weeks post-surgery for non-metastatic breast cancer (Stage 0-IIIb). We conducted Kaplan Meier (K-M) curves and Cox proportional hazards (PH) models to examine associations between depressive symptoms, overall survival, and disease-free survival at 8–15-year follow-up. Results A total of 95 women (41.1%) scored in the mild-moderately depressed range. Non-depressed women had longer overall survival (M = 13.56 years; SE = 0.26) than those in the mild/moderate depressed group (M = 11.45 years; SE = 0.40), Log-rank χ2(1) = 4.41, p = 0.036. Cox PH models, adjusting for covariates, showed comparable results: mild/moderate depressive symptoms hazard ratio = 2.56, [95% CI, 1.11 to 5.91], p = 0.027. Similar results were observed in a subsample with invasive disease (n = 191). Depression category did not predict disease-free survival in the overall or invasive sample. Conclusions Screening and referrals for treatment of depressive symptoms, even at subclinical levels, is important early in treatment. A randomized trial is warranted to determine effects of depressive symptoms on clinical outcomes.

Original languageEnglish (US)
Pages (from-to)16-21
Number of pages6
JournalGeneral Hospital Psychiatry
StatePublished - Jan 1 2017


  • Breast neoplasms
  • Depressive symptoms
  • Follow-up study
  • Recurrence
  • Survival

ASJC Scopus subject areas

  • Psychiatry and Mental health


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