title: Clinical recognition and management of depression in node negative breast cancer patients treated with tamoxifen.
abstract: Depression is not an uncommon complaint of women with breast cancer and is usually assumed to be related to the cancer diagnosis itself or its treatment. As part of a prospective clinical trial of adjuvant therapy of node negative breast cancer, 301 patients treated and assessed by one oncologist (SEJ) were serially questioned for symptoms of depression in the first 6-12 months after completing initial treatment (surgery, radiation therapy, and/or chemotherapy). Two hundred and fifty-seven patients were evaluable for assessment of depression; 155 were receiving tamoxifen and 102 were not. Twenty-six patients had symptoms of depression including 23 (15%) treated with tamoxifen compared to 3 (3%) in the group not placed on tamoxifen (p < 0.005). Of the 23 patients with depression in the tamoxifen group, symptoms were temporally related to the initiation of therapy and occurred generally in the first 2 months of treatment. Eight patients had mild symptoms not requiring a dose reduction, 8 had significant depression requiring a dose reduction to relieve symptoms, and 7 required discontinuation of tamoxifen. We conclude that clinical depression as a side effect of tamoxifen therapy may be more common than previously believed and should be further rigorously investigated to confirm or deny our clinical impressions.
authors.affiliation: Sammons Cancer Center, Baylor University Medical Center, Dallas, Texas 75246.
authors.forename: C K
authors.initials: CK
authors.lastname: Cathcart
authors.forename: S E
authors.initials: SE
authors.lastname: Jones
authors.forename: C S
authors.initials: CS
authors.lastname: Pumroy
authors.forename: G N
authors.initials: GN
authors.lastname: Peters
authors.forename: S M
authors.initials: SM
authors.lastname: Knox
authors.forename: J H
authors.initials: JH
authors.lastname: Cheek
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000188:drug therapy / Q000523:psychology*; D003863:Depression / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D013629:Tamoxifen / Q000009:adverse effects*
chemical_list: D013629:Tamoxifen