Correlation between hormone receptor status and depressive symptoms in patients with metastatic breast cancer
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Xiangyu Guo1,*, Junnan Xu1,*, Ying E1, Zhifu Yu2 and Tao Sun1
1Department of Internal Medicine 1, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Key Laboratory of Liaoning Breast Cancer Research, Shenyang, P. R. China
2Department of Epidemiology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, P. R. China
*These authors have contributed equally to this work
Tao Sun, email: [email protected]
Keywords: breast cancer, hormone receptor, depression, fluoxetine, SDS
Received: September 30, 2016 Accepted: January 16, 2017 Published: February 02, 2017
Individual differences in depressive symptoms correlate with morbidity and outcomes in breast cancer patients. We evaluated the effect of hormone receptor (HR) status on depressive symptoms in 176 women with metastatic breast cancer at diagnosis. To assess depression, the women completed Self-Rating Depression Scale (SDS) questionnaires at baseline examination (T1), after 4 chemotherapy cycles (T2) and after 6 months (T3). At baseline examination, 45/176 (25.6%) patients were found to be at high or medium risk for depression (SDS score ≥0.6). Among these, depression was both prevalent in HR-positive patients and in HR-negative patients (64.4% versus 51.4%, P = 0.001). In multivariate model, HR positivity and higher depression risk were associated with poorer overall survival (25.0 months versus 32.0 months, P < 0.05). Patients at high/medium risk of depression were treated with the antidepressant agent fluoxetine (N = 23) or no drug (N = 22). SDS scores in patients treated with fluoxetine were lower after 4 chemotherapy cycles and after 6 months than in the control group (mean scores: T2, 0.61 versus 0.67, P = 0.001; T3, 0.56 versus 0.65, P < 0.001). No difference on SDS scores was found between patients with positive or negative HR status during fluoxetine treatment. These findings suggest hormone receptor status is associated with depressive symptoms in patients with metastatic breast cancer. Fluoxetine relieves depressive symptoms in these patients, regardless of hormone receptor status.
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