Breast Cancer Research and Treatment

, Volume 123, Issue 2, pp 477–485 | Cite as

Depressive symptoms among young breast cancer survivors: the importance of reproductive concerns

  • Jessica R. Gorman
  • Vanessa L. Malcarne
  • Scott C. Roesch
  • Lisa Madlensky
  • John P. Pierce


Breast cancer diagnosis and treatment can negatively impact fertility in premenopausal women and influence reproductive planning. This study investigates whether concerns about reproduction after breast cancer treatment were associated with long-term depressive symptoms. Participants include 131 women diagnosed with early-stage breast cancer at age 40 or younger participating in the Women’s Healthy Eating and Living (WHEL) Survivorship Study. Participants were enrolled an average of 1.5 years postdiagnosis and depressive symptoms were monitored 6 times throughout the average additional 10 year follow-up period. Detailed recall of reproductive concerns after treatment was collected an average of 12 years postdiagnosis. Multilevel regression was used to evaluate whether mean long-term depressive symptoms differed as a function of reproductive concerns and significant covariates. Multilevel regression identified greater recalled reproductive concerns as an independent predictor of consistent depressive symptoms after controlling for both social support and physical health (B = 0.02, SE = 0.01, P = 0.04). In bivariate analyses, being nulliparous at diagnosis and reporting treatment-related ovarian damage were both strongly associated with higher reproductive concerns and with depressive symptoms. Reported reproductive concerns after breast cancer treatment were a significant contributor to consistent depressive symptoms. Younger survivors would benefit from additional information and support related to reproductive issues.


Breast cancer Young Depression Fertility Reproduction 



This study was initiated with the support of the California Breast Cancer Research Program (Grant 14GB-0140) and the Walton Family Foundation, and continued funding from National Cancer Institute Grants CA 69375 and CA 72092. Some of the data were collected from the General Clinical Research Centers, National Institutes of Health Grants M01-RR00070, M01-RR00079, and M01-RR00827.


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Copyright information

© Springer Science+Business Media, LLC. 2010

Authors and Affiliations

  • Jessica R. Gorman
    • 1
  • Vanessa L. Malcarne
    • 1
    • 2
  • Scott C. Roesch
    • 3
  • Lisa Madlensky
    • 1
  • John P. Pierce
    • 1
  1. 1.Cancer Prevention and Control Program, Moores UCSD Cancer CenterUniversity of California, San DiegoLa JollaUSA
  2. 2.Department of PsychologySan Diego State UniversitySan DiegoUSA
  3. 3.Department of PsychologySan Diego State UniversitySan DiegoUSA

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