Depressive mood disorders in patients with operable breast cancer

We studied 149 subjects admitted to hospital with operable, untreated breast cancer (108) or benign (41) breast disease (control group). Depression was evaluated before diagnosis and surgery, using MMPI and Rorschach tests, HDRS scale, and DSM-III-R diagnostic criteria during a semistructured interview. 62% of patients and 34% of controls (p<0.005) presented some depressive symptoms, whereas only 55% of patients and 18% of controls (p<0.001) met criteria for depressive mood disorders: 2% of patients and 0% of controls for major depression, 13% and 5% for dysthymia (p<0.05), 40% and 13% for depressive disorders NOS (p<0.001). No correlation was observed with respect to stage of disease, histopathologic grade, age and menopause except for ER status (p=0.03). During interview, 89% of patients and 65% of controls reported severe stressful life events 5+/-4 years before the clinical onset of the breast node. No differences were observed in the depression rating scales mean value whereas patients resulted more inhibited in their affection and emotionally controlled (Rorschach data) compared to controls (p<0.05). In conclusion, although the depression diagnostic criteria used may not be strictly correlated higher prevalence of depressive mood disorders and stressful life events were observed in patients in the pre-clinical phase of operable breast cancer. This may suggest an involvement of depression in the natural history of breast cancer.