Depression Induced by Total Mastectomy, Breast Conserving Surgery and Breast Reconstruction: A Systematic Review and...

Area of Science:

• Oncology
• Psychiatry
• Evidence-based Medicine

Background:

• Breast cancer surgery is a significant life event impacting patients' mental health.
• Postoperative depression is a concern for female breast cancer survivors.
• Understanding the long-term psychological effects of different surgical approaches is crucial for patient care.

Purpose of the Study:

• To systematically review and meta-analyze existing literature.
• To determine if different types of breast cancer surgery influence depression occurrence.
• To assess depression rates more than one year after surgery.

Main Methods:

• A comprehensive literature search was conducted across multiple databases (PubMed, Web of Science, EMBASE, OvidSP, EBSCO, PsycARTICLES).
• Observational clinical studies comparing depression incidence across different surgical groups were selected.
• A meta-analysis was performed on data from 16 included studies.

Main Results:

• Sixteen studies compared depression rates between total mastectomy (TM), breast conserving therapy (BCS), and breast reconstruction (BR).
• No statistically significant differences in depression occurrence were found among TM, BCS, and BR groups.
• Meta-analysis results: BCS vs. TM (RR=0.89, P=0.06), BR vs. TM (RR=0.87, P=0.16), BCS vs. BR (RR=1.10, P=0.37).

Conclusions:

• The type of surgery for breast cancer (TM, BCS, or BR) does not significantly affect the long-term occurrence of depressive symptoms.
• These findings suggest that surgical choice alone may not be a primary determinant of postoperative depression beyond one year.
• Further research may explore other contributing factors to long-term psychological well-being in breast cancer survivors.