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Breast Cancer Research and Treatment

, Volume 173, Issue 3, pp 709–717 | Cite as

Impact of pre-diagnosis depressive symptoms and health-related quality of life on treatment choice for ductal carcinoma in situ and stage I breast cancer in older women

  • Daniela L. Buscariollo
  • Angel M. Cronin
  • Nancy A. Borstelmann
  • Rinaa S. PungliaEmail author
Epidemiology

Abstract

Purpose

To examine whether pre-diagnosis patient-reported health-related quality of life (HRQOL) and depressive symptoms are associated with local treatment for older women with ductal carcinoma in situ (DCIS) and stage I breast cancer (BC).

Methods

Using the SEER-MHOS dataset, we identified women ≥ 65 years old with DCIS or stage I BC diagnosed 1998–2011 who completed surveys ≤ 24 months before diagnosis. Depressive symptoms were measured by major depressive disorder (MDD) risk and HRQOL was measured by Physical and Mental Component Summary scores (PCS and MCS, respectively) of the SF-36/VR-12. Associations with treatment choice (breast-conserving surgery [BCS] and radiation therapy [RT], BCS alone, mastectomy) were assessed with multivariable multinomial logistic regression, controlling for patient characteristics.

Results

We identified 425 women with DCIS and 982 with stage I BC. Overall, 20.4% endorsed depressive symptoms placing them at risk for MDD pre-diagnosis; mean MCS and PCS scores were 52.3 (SD = 10.1) and 40.5 (SD = 11.5), respectively. Among women with DCIS, those at risk for MDD were more likely to receive BCS (adjusted odds ratio [AOR] 2.04, 95% CI 1.04–4.00, p = 0.04) or mastectomy (AOR 1.88, 95% CI 0.91–3.86, p = 0.09) compared to BCS + RT. For DCIS, MCS score was not associated with treatment; higher PCS score was associated with decreased likelihood of receiving mastectomy versus BCS + RT (AOR 0.71 per 10-point increase, 95% CI 0.54–0.95, p = 0.02). For BC, none of the measures were significantly associated with treatment.

Conclusion

Older women at risk for MDD before DCIS diagnosis were less likely to receive RT after BCS, compared to BCS alone or mastectomy.

Keywords

Quality of life Depression DCIS Breast cancer Local therapy 

Notes

Funding

No external funding was received for this work. The views expressed in this article are those of the authors.

Compliance with ethical standards

Conflict of interest

None of the authors have any conflict of interest related to the subject matter presented.

Ethical approval

This survey study was approved by the Dana-Farber/Harvard Cancer Center (DFCI/HCC) IRB (Protocol #12–420). This article does not contain any studies with animals.

Supplementary material

10549_2018_5006_MOESM1_ESM.doc (176 kb)
Supplementary material 1 (DOC 175 KB)

References

  1. 1.
    Jemal A, Ward EM, Johnson CJ et al (2017) Annual report to the nation on the status of cancer, 1975–2014, featuring survival. JNCI 109:djx030CrossRefGoogle Scholar
  2. 2.
    Kerlikowske K (2010) Epidemiology of ductal carcinoma in situ. J the Natl Cancer Inst Monogr 2010:139–141CrossRefGoogle Scholar
  3. 3.
    Siegel RL, Miller KD, Jemal A (2017) Cancer statistics, 2017. CA Cancer J Clin 67:7–30CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Smith BD, Smith GL, Hurria A et al (2009) Future of cancer incidence in the United States: burdens upon an aging, changing nation. J Clin Oncol 27:2758–2765CrossRefPubMedGoogle Scholar
  5. 5.
    Biganzoli L, Wildiers H, Oakman C et al (2012) Management of elderly patients with breast cancer: updated recommendations of the International Society of Geriatric Oncology (SIOG) and European Society of Breast Cancer Specialists (EUSOMA). Lancet Oncol 13:e148–e160CrossRefPubMedGoogle Scholar
  6. 6.
    Tew WP, Muss HB, Kimmick GG et al (2014) Breast and ovarian cancer in the older woman. J Clin Oncol 32:2553–2561CrossRefPubMedGoogle Scholar
  7. 7.
    Early Breast Cancer Trialists’ Collaborative Group (EBCTCG), Correa C, McGale P et al (2010) Overview of the randomized trials of radiotherapy in ductal carcinoma in situ of the breast. J Natl Cancer Inst Monogr 2010:162–177CrossRefGoogle Scholar
  8. 8.
    Hughes KS, Schnaper LA, Bellon JR et al (2013) Lumpectomy plus tamoxifen with or without irradiation in women age 70 years or older with early breast cancer: long-term follow-up of CALGB 9343. J Clin Oncol 31:2382–2387CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Fyles AW, McCready DR, Manchul LA et al (2004) Tamoxifen with or without breast irradiation in women 50 years of age or older with early breast cancer. N Engl J Med 351:963–970CrossRefPubMedGoogle Scholar
  10. 10.
    Potter R, Gnant M, Kwasny W et al (2007) Lumpectomy plus tamoxifen or anastrozole with or without whole breast irradiation in women with favorable early breast cancer. Int J Radiat Oncol Biol Phys 68:334–340CrossRefPubMedGoogle Scholar
  11. 11.
    Kunkler IH, Williams LJ, Jack WJ et al (2015) Breast-conserving surgery with or without irradiation in women aged 65 years or older with early breast cancer (PRIME II): a randomised controlled trial. Lancet Oncol 16:266–273CrossRefPubMedGoogle Scholar
  12. 12.
    Day R, Ganz PA, Costantino JP (2001) Tamoxifen and depression: more evidence from the National Surgical Adjuvant Breast and Bowel Project’s Breast Cancer Prevention (P-1) Randomized Study. J Natl Cancer Inst 93:1615–1623CrossRefPubMedGoogle Scholar
  13. 13.
    Somerset W, Stout SC, Miller AH et al (2004) Breast cancer and depression. Oncology (Williston Park) 18:1021–1034 1047–8Google Scholar
  14. 14.
    Monti DA, Mago R, Kunkel EJ (2005) Practical geriatrics: depression, cognition, and anxiety among postmenopausal women with breast cancer. Psychiatr Serv 56:1353–1355CrossRefPubMedGoogle Scholar
  15. 15.
    Bardwell WA, Natarajan L, Dimsdale JE et al (2006) Objective cancer-related variables are not associated with depressive symptoms in women treated for early-stage breast cancer. J Clin Oncol 24:2420–2427CrossRefPubMedGoogle Scholar
  16. 16.
    Weitzner MA, Meyers CA, Stuebing KK et al (1997) Relationship between quality of life and mood in long-term survivors of breast cancer treated with mastectomy. Support Care Cancer 5:241–248CrossRefPubMedGoogle Scholar
  17. 17.
    Fulton C (1999) Patients with metastatic breast cancer: their physical and psychological rehabilitation needs. Int J Rehabil Res 22:291–301CrossRefPubMedGoogle Scholar
  18. 18.
    Badger TA, Braden CJ, Mishel MH et al (2004) Depression burden, psychological adjustment, and quality of life in women with breast cancer: patterns over time. Res Nurs Health 27:19–28CrossRefPubMedGoogle Scholar
  19. 19.
    Hjerl K, Andersen EW, Keiding N et al (2003) Depression as a prognostic factor for breast cancer mortality. Psychosomatics 44:24–30CrossRefPubMedGoogle Scholar
  20. 20.
    Watson M, Haviland JS, Greer S et al (1999) Influence of psychological response on survival in breast cancer: a population-based cohort study. Lancet 354:1331–1336CrossRefPubMedGoogle Scholar
  21. 21.
    Colleoni M, Mandala M, Peruzzotti G et al (2000) Depression and degree of acceptance of adjuvant cytotoxic drugs. Lancet 356:1326–1327CrossRefPubMedGoogle Scholar
  22. 22.
    Ayres A, Hoon PW, Franzoni JB et al (1994) Influence of mood and adjustment to cancer on compliance with chemotherapy among breast cancer patients. J Psychosom Res 38:393–402CrossRefPubMedGoogle Scholar
  23. 23.
    Ambs A, Warren JL, Bellizzi KM et al (2008) Overview of the SEER–Medicare Health Outcomes Survey linked dataset. Health Care Financ Rev 29:5–21PubMedPubMedCentralGoogle Scholar
  24. 24.
    National Cancer Institute: Overview of the SEER program. http://seer.cancer.gov/about/overview.html
  25. 25.
    Rost K, Burnam MA, Smith GR (1993) Development of screeners for depressive disorders and substance disorder history. Med Care 31:189–200CrossRefPubMedGoogle Scholar
  26. 26.
    White AJ, Reeve BB, Chen RC et al (2014) Coexistence of urinary incontinence and major depressive disorder with health-related quality of life in older Americans with and without cancer. J Cancer Surviv 8:497–507CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Turner-Bowker DM, Bartley PJ, Ware JE Jr (2002) SF-36® Health Survey & “SF” bibliography: third edition (1988–2000). Lincoln, RIGoogle Scholar
  28. 28.
    Selim AJ, Rogers W, Fleishman JA et al (2009) Updated U.S. population standard for the Veterans RAND 12-item Health Survey (VR-12). Qual Life Res 18:43–52CrossRefPubMedGoogle Scholar
  29. 29.
    Ware JE Jr, Snow K, Kosinski M (2000) SF-36 health survey manual and interpretation guide. TheHealth Institute, NewEngland Medical Center, BostonGoogle Scholar
  30. 30.
    Sepucha KR, Belkora JK, Chang Y et al (2012) Measuring decision quality: psychometric evaluation of a new instrument for breast cancer surgery. BMC Med Inform Decis Mak 12:51CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Waljee JF, Rogers MA, Alderman AK (2007) Decision aids and breast cancer: do they influence choice for surgery and knowledge of treatment options? J Clin Oncol 25:1067–1073CrossRefPubMedGoogle Scholar
  32. 32.
    Whelan T, Levine M, Willan A et al (2004) Effect of a decision aid on knowledge and treatment decision making for breast cancer surgery: a randomized trial. JAMA 292:435–441CrossRefPubMedGoogle Scholar
  33. 33.
    Street RL Jr, Voigt B, Geyer C Jr et al (1995) Increasing patient involvement in choosing treatment for early breast cancer. Cancer 76:2275–2285CrossRefPubMedGoogle Scholar
  34. 34.
    Ozanne EM, Schneider KH, Soeteman D et al (2015) onlineDeCISion.org: a web-based decision aid for DCIS treatment. Breast Cancer Res Treat 154:181–190CrossRefPubMedGoogle Scholar
  35. 35.
    Gumus M, Ustaalioglu BO, Garip M et al (2010) Factors that affect patients’ decision-making about mastectomy or breast conserving surgery, and the psychological effect of this choice on breast cancer patients. Breast Care (Basel) 5:164–168CrossRefGoogle Scholar
  36. 36.
    Chagpar AB, Studts JL, Scoggins CR et al (2006) Factors associated with surgical options for breast carcinoma. Cancer 106:1462–1466CrossRefPubMedGoogle Scholar
  37. 37.
    Satariano ER, Swanson GM, Moll PP (1992) Nonclinical factors associated with surgery received for treatment of early-stage breast cancer. Am J Public Health 82:195–198CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Guadagnoli E, Weeks JC, Shapiro CL et al (1998) Use of breast-conserving surgery for treatment of stage I and stage II breast cancer. J Clin Oncol 16:101–106CrossRefPubMedGoogle Scholar
  39. 39.
    Omer ZB, Hwang ES, Esserman LJ et al (2013) Impact of ductal carcinoma in situ terminology on patient treatment preferences. JAMA Intern Med 173:1830–1831CrossRefPubMedGoogle Scholar
  40. 40.
    Iglay K, Santorelli ML, Hirshfield KM et al (2017) Impact of preexisting mental illness on all-cause and breast cancer–specific mortality in elderly patients with breast cancer. J Clin Oncol 35(36):4012–4018CrossRefPubMedGoogle Scholar
  41. 41.
    Goodwin JS, Zhang DD, Ostir GV (2004) Effect of depression on diagnosis, treatment, and survival of older women with breast cancer. J Am Geriatr Soc 52:106–111CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Simon GE (2003) Social and economic burden of mood disorders. Biol Psychiatry 54:208–215CrossRefPubMedGoogle Scholar
  43. 43.
    Kanani R, Davies EA, Hanchett N et al (2016) The association of mood disorders with breast cancer survival: an investigation of linked cancer registration and hospital admission data for South East England. Psychooncology 25:19–27CrossRefPubMedGoogle Scholar
  44. 44.
    Smit F, Ederveen A, Cuijpers P et al (2006) Opportunities for cost-effective prevention of late-life depression: an epidemiological approach. Arch Gen Psychiatry 63:290–296CrossRefPubMedGoogle Scholar
  45. 45.
    VanItallie TB (2005) Subsyndromal depression in the elderly: underdiagnosed and undertreated. Metabolism 54:39–44CrossRefPubMedGoogle Scholar
  46. 46.
    Steffens DC, Fisher GG, Langa KM et al (2009) Prevalence of depression among older Americans: the aging, demographics and memory study. Int Psychogeriatr 21:879–888CrossRefPubMedPubMedCentralGoogle Scholar
  47. 47.
    Zivin K, Llewellyn DJ, Lang IA et al (2010) Depression among older adults in the United States and England. Am J Geriatr Psychiatry 18:1036–1044CrossRefPubMedPubMedCentralGoogle Scholar
  48. 48.
    Davidson JR, Meltzer-Brody SE (1999) The underrecognition and undertreatment of depression: what is the breadth and depth of the problem? J Clin Psychiatry 60(Suppl 7):4–9 discussion 10–11PubMedGoogle Scholar
  49. 49.
    McCall NT, Parks P, Smith K et al (2002) The prevalence of major depression or dysthymia among aged Medicare Fee-for-Service beneficiaries. Int J Geriatr Psychiatry 17:557–565CrossRefPubMedGoogle Scholar
  50. 50.
    Volkers AC, Nuyen J, Verhaak PF et al (2004) The problem of diagnosing major depression in elderly primary care patients. J Affect Disord 82:259–263CrossRefPubMedGoogle Scholar
  51. 51.
    Koenig HG, George LK, Peterson BL et al (1997) Depression in medically ill hospitalized older adults: prevalence, characteristics, and course of symptoms according to six diagnostic schemes. Am J Psychiatry 154:1376–1383CrossRefPubMedGoogle Scholar
  52. 52.
    Zisberg A (2017) Anxiety and depression in older patients: the role of culture and acculturation. Int J Equity Health 16:177CrossRefPubMedPubMedCentralGoogle Scholar
  53. 53.
    Garside RB, Klimes-Dougan B (2002) Socialization of discrete negative emotions: gender differences and links with psychological distress. Sex Roles 47:115–128CrossRefGoogle Scholar
  54. 54.
    Betancourt JR, Green AR, Carrillo JE et al (2003) Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care. Public Health Rep 118:293–302CrossRefPubMedPubMedCentralGoogle Scholar
  55. 55.
    Fossati P, Coyette F, Ergis AM et al (2002) Influence of age and executive functioning on verbal memory of inpatients with depression. J Affect Disord 68:261–271CrossRefPubMedGoogle Scholar
  56. 56.
    Porter RJ, Gallagher P, Thompson JM et al (2003) Neurocognitive impairment in drug-free patients with major depressive disorder. Br J Psychiatry 182:214–220CrossRefPubMedGoogle Scholar
  57. 57.
    Pantel J, Schroder J, Essig M et al (1997) Quantitative magnetic resonance imaging in geriatric depression and primary degenerative dementia. J Affect Disord 42:69–83CrossRefPubMedGoogle Scholar
  58. 58.
    Sheline YI, Wang PW, Gado MH et al (1996) Hippocampal atrophy in recurrent major depression. Proc Natl Acad Sci U S A 93:3908–3913CrossRefPubMedPubMedCentralGoogle Scholar
  59. 59.
    Hugo M (2001) Mental health professionals’ attitudes towards people who have experienced a mental health disorder. J Psychiatr Ment Health Nurs 8:419–425CrossRefPubMedGoogle Scholar
  60. 60.
    Thornicroft G, Rose D, Kassam A (2007) Discrimination in health care against people with mental illness. Int Rev Psychiatry 19:113–122CrossRefPubMedGoogle Scholar
  61. 61.
    Hughes KS, Schnaper LA, Berry D et al (2004) Lumpectomy plus tamoxifen with or without irradiation in women 70 years of age or older with early breast cancer. N Engl J Med 351:971–977CrossRefPubMedGoogle Scholar
  62. 62.
    Carlson RW, McCormick B (2005) Update: NCCN breast cancer clinical practice guidelines. J Natl Compr Cancer Netw 3(Suppl 1):S7–S11Google Scholar
  63. 63.
    Soulos PR, Yu JB, Roberts KB et al (2012) Assessing the impact of a cooperative group trial on breast cancer care in the medicare population. J Clin Oncol 30:1601–1607CrossRefPubMedPubMedCentralGoogle Scholar
  64. 64.
    McCormick B, Ottesen RA, Hughes ME et al (2014) Impact of guideline changes on use or omission of radiation in the elderly with early breast cancer: practice patterns at National Comprehensive Cancer Network institutions. J Am Coll Surg 219:796–802CrossRefPubMedGoogle Scholar
  65. 65.
    Palta M, Palta P, Bhavsar NA et al (2015) The use of adjuvant radiotherapy in elderly patients with early-stage breast cancer: changes in practice patterns after publication of Cancer and Leukemia Group B 9343. Cancer 121:188–193CrossRefPubMedGoogle Scholar
  66. 66.
    Practice guideline for the (2007) breast conservation therapy in the management of invasive breast carcinoma. J Am Coll Surg 205:362–376CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Daniela L. Buscariollo
    • 1
  • Angel M. Cronin
    • 2
  • Nancy A. Borstelmann
    • 3
  • Rinaa S. Punglia
    • 1
    Email author
  1. 1.Department of Radiation OncologyBrigham and Women’s Hospital and Dana-Farber Cancer Institute, Harvard Medical SchoolBostonUSA
  2. 2.Center for Outcomes and Policy ResearchDana-Farber Cancer Institute, Harvard Medical SchoolBostonUSA
  3. 3.Department of Psychosocial Oncology and Palliative CareDana-Farber Cancer InstituteBostonUSA

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