Clinical recognition and management of depression in node negative breast cancer patients treated with tamoxifen
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Depression is not an uncommon complaint of women with breast cancer and is usually assumed to be related to the cancer diagnosis itself or its treatment. As part of a prospective clinical trial of adjuvant therapy of node negative breast cancer, 301 patients treated and assessed by one oncologist (SEJ) were serially questioned for symptoms of depression in the first 6–12 months after completing initial treatment (surgery, radiation therapy, and/or chemotherapy). Two hundred and fifty-seven patients were evaluable for assessment of depression; 155 were receiving tamoxifen and 102 were not. Twenty-six patients had symptoms of depression including 23 (15%) treated with tamoxifen compared to 3 (3%) in the group not placed on tamoxifen (p < 0.005). Of the 23 patients with depression in the tamoxifen group, symptoms were temporally related to the initiation of therapy and occurred generally in the first 2 months of treatment. Eight patients had mild symptoms not requiring a dose reduction, 8 had significant depression requiring a dose reduction to relieve symptoms, and 7 required discontinuation of tamoxifen. We conclude that clinical depression as a side effect of tamoxifen therapy may be more common than previously believed and should be further rigorously investigated to confirm or deny our clinical impressions.
Key wordsantiestrogens breast cancer depression tamoxifen
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- 1.Legha SS: Tamoxifen in the treatment of breast cancer. Ann Intern Med 109: 219–228, 1988Google Scholar
- 2.Love RR, Cameron L, Connell BL, Leventhal H: Symptoms associated with tamoxifen treatment in postmenopausal women. Arch Intern Med 151: 1842–1847, 1991Google Scholar
- 3.Clark GM, Dressler LG, Owens MA, Pounds G, Oldaker T, McGuire WL: Prediction of relapse or survival in patients with node-negative breast cancer by DNA flow cytometry. N Engl J Med 320: 627–633, 1989Google Scholar
- 4.Formander T, Cedermark B, Mattsson A, Theve T, Askergren J, Rutqvist, Glas U, Silfversward C, Somell A, Wilking H, Hjalmar M: Adjuvant tamoxifen in early breast cancer: occurrence of new primary cancers. Lancet 1: 117, 1989Google Scholar
- 5.Love RR, Surawicz TS, Williams EC: Antithrombin III level, fibrinogen level, and platelet count changes with adjuvant tamoxifen therapy. Arch Intern Med 152: 317–320, 1992Google Scholar
- 6.Love RR: Tamoxifen prophylaxis in breast cancer. Oncology 6 (7): 33–43, 1992Google Scholar
- 7.Vogel GV: Prevention of breast cancer with tamoxifen. Cancer Bulletin 43: 569–573, 1991Google Scholar
- 8.Santen RJ, Manni A, Harvey H, Redmond C: Endocrine treatment of breast cancer in women. Endocrine Reviews 11 (2): 221–265, 1990Google Scholar