Prognostic value of patient-reported depression in women with hormone-responsive early breast cancer in TEXT and SOFT

Ribi, K; Cole, BF; Fleming, GF; Walley, BA; Francis, PA; Abdi, E; Burstein, HJ; Cheng, KL; Chia, SKL; Dakhil, SR; Davidson, NE; Della-Fiorentina, SA; Frith, AE; Levine, E; Lupichuk, S; Pritchard, K; Salim, M; Stearns, V; Stewart, J; Valero, V; van der Westhuizen, A; Pagani, O; Loi, S; Colleoni, M; Gelber, RD; Goldhirsch, A; Coates, AS; Regan, MM; Bernhard, J

Author(s): Ribi, K; Cole, BF; Fleming, GF; Walley, BA; Francis, PA; Abdi, E; Burstein, HJ; Cheng, KL; Chia, SKL; Dakhil, SR; Davidson, NE; Della-Fiorentina, SA; Frith, AE; Levine, E; Lupichuk, S; Pritchard, K; Salim, M; Stearns, V; Stewart, J; Valero, V; van der Westhuizen, A; Pagani, O; Loi, S; Colleoni, M; Gelber, RD; Goldhirsch, A; Coates, AS; Regan, MM; Bernhard, J;
Details: Publication Year 2025-10-01,Volume 131,Issue #19,Page e70094
Journal Title: Cancer
Publication Type: Research article
Abstract: BACKGROUND: Depression has been identified as an adverse mental health outcome in women with breast cancer (BC). Depression was investigated as a risk factor for poor survival in premenopausal women with hormone-responsive early BC treated in the TEXT (Tamoxifen and Exemestane Trial) and SOFT (Suppression of Ovarian Function Trial) trials. METHODS: The data used were from a subset of patients who participated in TEXT or SOFT and completed the Center of Epidemiologic Studies-Depression scale. Associations between baseline depression-score categories and baseline characteristics were assessed using the Cochran-Mantel-Haenszel test controlling for antidepressant use. Multivariable proportional hazards regression models were used to test the association between baseline depression and disease-free survival (DFS) and overall survival (OS). Regression models were adjusted for factors known to be associated with outcomes, baseline antidepressant use, and early treatment cessation. RESULTS: Forty percent (2287 of 5738) of the women enrolled in the SOFT and TEXT trials were included in this analysis (SOFT, n = 1259; TEXT, n = 1028). Twenty-seven percent of women reported mild-to-moderate or severe depression at baseline. Race (p = .001), body mass index (p = .02), family history (p = .02), and performance status (p =.007) were significantly associated with the severity of depression. Relative to the no-symptomatology group, the hazard ratios (overall p = .04) for DFS were 1.34 (95% confidence interval [CI], 1.03-1.76) for women with mild-to-moderate depression and 1.34 (95% CI, 0.96-1.87) for those with severe depression. Relative to the no-symptomatology group, the hazard ratios (overall p = .008) for OS were 1.68 for mild-to-moderate depression (95% CI, 1.15-2.44) and 1.67 for those with severe depression (95% CI, 1.05-2.66). CONCLUSIONS: In premenopausal women with hormone-responsive early BC, depression at baseline is a risk factor for poorer DFS and OFS. Further investigation of the underlying interactive processes is needed. TRIAL REGISTRATION: Clinicaltrials.gov NCT00066703 (SOFT) and NCT00066690 (TEXT).
Publisher: Wiley
Keywords: Adult; Female; Humans; Middle Aged; Androstadienes/administration & dosage/therapeutic use; Antidepressive Agents/therapeutic use; Antineoplastic Combined Chemotherapy Protocols/therapeutic use; *Breast Neoplasms/drug therapy/psychology/mortality/complications; *Depression/drug therapy; Disease-Free Survival; Premenopause; Prognosis; Tamoxifen/therapeutic use/administration & dosage; depression; disease‐free survival; early breast cancer; hormone‐responsive; overall survival; premenopausal; prevalence
Department(s): Medical Oncology
Publisher's Version: https://doi.org/10.1002/cncr.70094
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2025-10-23 05:42:29

Last Modified: 2025-10-23 05:42:43