title: Effect of depression before breast cancer diagnosis on mortality among postmenopausal women.
abstract: BACKGROUND
  Few previous studies investigating depression before the diagnosis of breast cancer and breast cancer-specific mortality have examined depression measured at more than 1 time point. This study investigated the effect of depression (combining depressive symptoms alone with antidepressant use) measured at 2 time points before the diagnosis of breast cancer on all-cause mortality and breast cancer-specific mortality among older postmenopausal women.
  
  
  METHODS
  A large prospective cohort, the Women's Health Initiative, was used. The study included 3095 women with incident breast cancer who had measures of depressive symptoms and antidepressant use before their diagnosis at the baseline and at year 3. Multivariate Cox proportional hazards regression was used to estimate adjusted hazard ratios (HRs) between depression at the baseline, depression at year 3, and combinations of depression at these time points and all-cause mortality and breast cancer-specific mortality.
  
  
  RESULTS
  Depression at year 3 before a breast cancer diagnosis was associated with higher all-cause mortality after adjustments for multiple covariates (HR, 1.35; 95% confidence interval [CI], 1.02-1.78). There was no statistically significant association of baseline depression and all-cause mortality or breast cancer-specific mortality whether or not depression was also present at year 3. In women with late-stage (regional- or distant-stage) breast cancer, newly developed depression at year 3 was significantly associated with both all-cause mortality (HR, 2.00; 95% CI, 1.13-3.56) and breast cancer-specific mortality (HR, 2.42; 95% CI, 1.24-4.70).
  
  
  CONCLUSIONS
  Women with newly developed depression before the diagnosis of breast cancer had a modestly but significantly increased risk for death from any cause and for death from breast cancer at a late stage. Cancer 2017;123:3107-15. © 2017 American Cancer Society.
authors.affiliation: School of Social Development and Public Policy, Beijing Normal University, Beijing, China.
authors.forename: Xiaoyun
authors.identifier: http://orcid.org/0000-0001-6626-8091
authors.initials: X
authors.lastname: Liang
authors.affiliation: HealthPartners Institute, Minneapolis, Minnesota.
authors.forename: Karen L
authors.initials: KL
authors.lastname: Margolis
authors.affiliation: Department of Applied Health Science, School of Public Health, Indiana University Bloomington, Bloomington, Indiana.
authors.forename: Michael
authors.initials: M
authors.lastname: Hendryx
authors.affiliation: Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, Massachusetts.
authors.forename: Katherine
authors.initials: K
authors.lastname: Reeves
authors.affiliation: Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Wassertheil-Smoller
authors.affiliation: Veterans Affairs Palo Alto Health Care System, Palo Alto, California.|Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California.
authors.forename: Julie
authors.initials: J
authors.lastname: Weitlauf
authors.affiliation: Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
authors.forename: Suzanne C
authors.initials: SC
authors.lastname: Danhauer
authors.affiliation: Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, California.
authors.forename: Rowan T
authors.initials: RT
authors.lastname: Chlebowski
authors.affiliation: Division of Research, Kaiser Permanente, Oakland, California.
authors.forename: Bette
authors.initials: B
authors.lastname: Caan
authors.affiliation: Department of Public Health Sciences, University of California Davis, Davis, California.
authors.forename: Lihong
authors.initials: L
authors.lastname: Qi
authors.affiliation: Department of Family, Population, and Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, New York.
authors.forename: Dorothy
authors.initials: D
authors.lastname: Lane
authors.affiliation: Memorial Cancer Institute, Memorial Health Care System, Florida International University, Hollywood, Florida.
authors.forename: Sayeh
authors.initials: S
authors.lastname: Lavasani
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Indiana University Bloomington, Bloomington, Indiana.
authors.forename: Juhua
authors.initials: J
authors.lastname: Luo
mesh_terms: D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000473:pathology; D002423:Cause of Death; D015331:Cohort Studies; D015897:Comorbidity; D003863:Depression / Q000188:drug therapy / Q000453:epidemiology*; D003866:Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009026:Mortality; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D017698:Postmenopause; D016016:Proportional Hazards Models; D011446:Prospective Studies
chemical_list: D000928:Antidepressive Agents
keywords: Cox proportional hazards regression model; breast cancer; depression; mortality; postmenopausal women