Association Between Depression and Anxiety Status of Breast Cancer Patients Undergoing Adjuvant Chemotherapy and Chemotherapy-induced Adverse Events.

Abstract Purpose: The response to a breast cancer diagnosis encompasses aspects related to emotion and psychology, and patients with breast cancer are more likely to experience psychological distress. This study therefore aimed to explore the relationship between depression and anxiety status and adverse events during adjuvant chemotherapy in Chinese breast cancer patients.Methods: This prospective study was conducted on 290 postoperative early-stage breast cancer patients (response rate 96.7%) in China. Depression and anxiety status before adjuvant chemotherapy and after 2 cycles of chemotherapy were assessed by the Hospital Anxiety and Depression Scale (HADS). Adverse events that occurred throughout the course of chemotherapy were graded and recorded according to CTCAE 4.02.Results: The rates of depression and anxiety were 20.0% and 31.4%, respectively, at baseline. After 2 cycles of chemotherapy, the rates of depression and anxiety were 25.2% and 29.0%, respectively. The incidence of grade two or higher myelosuppression induced by chemotherapy was correlated with depression before chemotherapy (P=0.037) and after 2 cycles of chemotherapy (P=0.009). Multivariate analysis showed that the incidence of myelosuppression was significantly related to depression before chemotherapy (P=0.032) and after 2 cycles of chemotherapy (P=0.006). There was no association between depression and anxiety status and other adverse events (P>0.05).Conclusions: We observed an association between depression and anxiety status in breast cancer patients receiving adjuvant chemotherapy and chemotherapy-induced myelosuppression. Monitoring the psychological status of breast cancer patients undergoing chemotherapy may help to optimize the management of adverse events.The study is registered (ClinicalTrials.gov identifier: NCT05055375)