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Radical Mastectomy Linked to Higher Mental Health Risks
Recent findings from a group of Polish researchers indicate that the options used for breast cancer treatment have a significant impact on women’s risks for developing depression or anxiety.
Broadly speaking, any woman (or man) dealing with breast cancer has increased chances of developing depression-related or anxiety-related mental health problems. In a study published in early 2015 in the Annals of Agricultural and Environmental Medicine, researchers from three Polish institutions gauged the impact that specific methods of breast cancer treatment have on the chances that a woman will develop depression- or anxiety-related issues. These researchers concluded that women who receive a radical mastectomy for breast cancer have higher mental health risks than women who receive more conservative forms of treatment that leave breast tissue essentially intact.
Breast Cancer Treatments
The National Cancer Institute lists six distinct approaches to breast cancer treatment: surgery, surgery preceded by a procedure called a sentinel lymph node biopsy, radiation therapy, chemotherapy, hormone therapy and targeted therapy. Forms of breast cancer surgery include breast tissue-conserving options such as a lumpectomy and a partial mastectomy, as well as more extreme options such as a radical mastectomy (total breast removal) and a modified radical mastectomy. A sentinel lymph node biopsy before surgery is intended to prevent the spread of breast cancer to other parts of the body. Radiation therapy uses X-rays or other radiation sources to induce cancer cell death, while chemotherapy uses oral or injected medications to produce a system-wide form of the same essential effect. Hormone therapy addresses breast cancer by blocking or eliminating hormones in the body that support cancer growth, while targeted therapy uses medications or antibodies to kill off cancer cells without harming healthy cells.
Doctors consider a number of variables when deciding which treatments to use in people with breast cancer. These variables include the specific form of breast cancer present, the extent of cancer in the body, the speed of cancer growth, the seriousness of hormone-related cancer progression, the age of the patient, the patient’s overall health, whether or not a woman has gone through menopause, the likelihood that breast cancer will recur after treatment and whether or not a particular patient has new-onset or recurring breast cancer.
Cancer and Mental Health
As many as 25 percent of all people affected by breast cancer and other forms of cancer have diagnosable symptoms of a depression-related illness, the American Cancer Society notes. Depression in a cancer patient can lead to serious problems that include a reduced ability to maintain a functional daily routine and a reduced ability to follow an appropriate treatment regimen. Cancer-related anxiety typically reaches its peak at the time of initial diagnosis and/or at the time of any cancer recurrence. Some people with cancer begin to experience bouts of extreme anxiety known as panic attacks. An individual who experiences repeated panic attacks may qualify for an official diagnosis of a condition called panic disorder.
Impact of Treatment Options
In the study published in the Annals of Agricultural and Environmental Medicine, researchers from Poland’s St. John’s Cancer Center, Medical University of Lublin and Institute of Rural Health used a project involving 179 women to compare the depression- and anxiety-related risks of a radical mastectomy for breast cancer to the risks associated with less extreme forms of treatment that save as much breast tissue as possible. Ninety-four of the study participants underwent a radical mastectomy, while the remaining participants underwent more conservative forms of treatment. The researchers used a standard screening tool called the Beck Depression Inventory to assess each woman’s depression levels. They used another screening tool called the Hospital Anxiety and Depression Scale to assess each woman’s anxiety levels.
The researchers found that the women who underwent a radical mastectomy had an average score of 7.8 out of 21 on the Hospital Anxiety and Depression Scale, while the women who received more conservative forms of treatment had a significantly lower average score of 6.96. The researchers also found that the women who underwent a radical mastectomy had an average Beck Depression Inventory score of 19.6 out of 63, while the women who received more conservative forms of treatment had a significantly lower score of 16.3. In terms of a depression diagnosis, the specific form of breast cancer treatment in use appears to contribute to the difference between mild depression (associated with conservative treatment) and moderate depression (associated with radical mastectomy).