Are breast cancer patients with low distress at diagnosis at risk of psychological symptoms later in their disease trajectory? Considerations for when to screen for distress
Introduction: To target psychological support to cancer patients most in need of support, screening for psychological distress has been advocated and, in some settings, also implemented. Still, no prior studies have examined the appropriate ‘dosage’ and whether screening for distress before cancer t...
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| Format: | Article |
| Language: | English |
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Medical Journals Sweden
2025-01-01
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| Series: | Acta Oncologica |
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| Online Access: | https://medicaljournalssweden.se/actaoncologica/article/view/42367 |
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| author | Rikke Langballe Birgitte Mertz Niels Kroman Thomas Maltesen Susanne Rosthøj Pernille Envold Bidstrup |
| author_facet | Rikke Langballe Birgitte Mertz Niels Kroman Thomas Maltesen Susanne Rosthøj Pernille Envold Bidstrup |
| author_sort | Rikke Langballe |
| collection | DOAJ |
| description | Introduction: To target psychological support to cancer patients most in need of support, screening for psychological distress has been advocated and, in some settings, also implemented. Still, no prior studies have examined the appropriate ‘dosage’ and whether screening for distress before cancer treatment may be sufficient or if further screenings during treatment are necessary. We examined the development in symptom trajectories for breast cancer patients with low distress before surgery and explored potential risk factors for developing burdensome symptoms at a later point in time.
Methods: In total, 299 patients newly diagnosed with breast cancer who scored < 7 on the distress thermometer were included between August 2017 and October 2019 at the Department of Breast Surgery, Rigshospitalet, Copenhagen. Patients were followed through electronic questionnaires at baseline before surgery and after 6, 12, and 18 months. We used latent class mixed models to identify sub-groups of patients with similar development in distress, anxiety, depression, breast cancer-specific health-related quality of life, self-efficacy, and fear of recurrence over time. Logistic and multinomial regression analyses were applied to examine clinical and sociodemographic factors associated with specific symptom trajectories.
Results: We did not identify any sub-groups of women with low distress at diagnosis who developed disabling psychological symptoms up to 18 months after diagnosis. However, we did identify a sub-group of 52% of the women who experienced persistent mild anxiety (Generalised Anxiety Disorder [GAD]-7 score 5–9). Adjusted for baseline treatment modalities and sociodemographic characteristics, women having low social support (odds ratio [OR]: 2.90; 95% confidence interval [CI]: 1.07–7.87) or living with a partner (OR: 3.18; 95% CI: 1.38–7.34) were more likely to experience persistent mild anxiety.
Interpretation: The results show that the majority of women with low distress at breast cancer diagnosis do not experience an increase in psychological symptoms over time. Screening for distress at cancer diagnosis may be an essential step to identify most breast cancer patients in need of professional support for psychological symptoms.
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| format | Article |
| id | doaj-art-21176c84318e44deba9642d5b94ba3a3 |
| institution | Kabale University |
| issn | 1651-226X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Oncologica |
| spelling | doaj-art-21176c84318e44deba9642d5b94ba3a32025-01-26T07:17:02ZengMedical Journals SwedenActa Oncologica1651-226X2025-01-016410.2340/1651-226X.2025.42367Are breast cancer patients with low distress at diagnosis at risk of psychological symptoms later in their disease trajectory? Considerations for when to screen for distressRikke Langballe0Birgitte Mertz1Niels Kroman2Thomas Maltesen3Susanne Rosthøj4Pernille Envold Bidstrup5Psychological Aspects of Cancer, Cancer Survivorship, The Danish Cancer Institute, Copenhagen, Denmark; Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Roskilde, DenmarkDepartment of Breast Cancer Surgery, Rigshospitalet, Copenhagen, DenmarkDepartment of Breast Cancer Surgery, Rigshospitalet, Copenhagen, DenmarkStatistics and Data Analysis, The Danish Cancer Institute, Copenhagen, Denmark Statistics and Data Analysis, The Danish Cancer Institute, Copenhagen, DenmarkPsychological Aspects of Cancer, Cancer Survivorship, The Danish Cancer Institute, Copenhagen, DenmarkIntroduction: To target psychological support to cancer patients most in need of support, screening for psychological distress has been advocated and, in some settings, also implemented. Still, no prior studies have examined the appropriate ‘dosage’ and whether screening for distress before cancer treatment may be sufficient or if further screenings during treatment are necessary. We examined the development in symptom trajectories for breast cancer patients with low distress before surgery and explored potential risk factors for developing burdensome symptoms at a later point in time. Methods: In total, 299 patients newly diagnosed with breast cancer who scored < 7 on the distress thermometer were included between August 2017 and October 2019 at the Department of Breast Surgery, Rigshospitalet, Copenhagen. Patients were followed through electronic questionnaires at baseline before surgery and after 6, 12, and 18 months. We used latent class mixed models to identify sub-groups of patients with similar development in distress, anxiety, depression, breast cancer-specific health-related quality of life, self-efficacy, and fear of recurrence over time. Logistic and multinomial regression analyses were applied to examine clinical and sociodemographic factors associated with specific symptom trajectories. Results: We did not identify any sub-groups of women with low distress at diagnosis who developed disabling psychological symptoms up to 18 months after diagnosis. However, we did identify a sub-group of 52% of the women who experienced persistent mild anxiety (Generalised Anxiety Disorder [GAD]-7 score 5–9). Adjusted for baseline treatment modalities and sociodemographic characteristics, women having low social support (odds ratio [OR]: 2.90; 95% confidence interval [CI]: 1.07–7.87) or living with a partner (OR: 3.18; 95% CI: 1.38–7.34) were more likely to experience persistent mild anxiety. Interpretation: The results show that the majority of women with low distress at breast cancer diagnosis do not experience an increase in psychological symptoms over time. Screening for distress at cancer diagnosis may be an essential step to identify most breast cancer patients in need of professional support for psychological symptoms. https://medicaljournalssweden.se/actaoncologica/article/view/42367Breast cancercancer survivorshipsymptom trajectoriespsychological distress |
| spellingShingle | Rikke Langballe Birgitte Mertz Niels Kroman Thomas Maltesen Susanne Rosthøj Pernille Envold Bidstrup Are breast cancer patients with low distress at diagnosis at risk of psychological symptoms later in their disease trajectory? Considerations for when to screen for distress Acta Oncologica Breast cancer cancer survivorship symptom trajectories psychological distress |
| title | Are breast cancer patients with low distress at diagnosis at risk of psychological symptoms later in their disease trajectory? Considerations for when to screen for distress |
| title_full | Are breast cancer patients with low distress at diagnosis at risk of psychological symptoms later in their disease trajectory? Considerations for when to screen for distress |
| title_fullStr | Are breast cancer patients with low distress at diagnosis at risk of psychological symptoms later in their disease trajectory? Considerations for when to screen for distress |
| title_full_unstemmed | Are breast cancer patients with low distress at diagnosis at risk of psychological symptoms later in their disease trajectory? Considerations for when to screen for distress |
| title_short | Are breast cancer patients with low distress at diagnosis at risk of psychological symptoms later in their disease trajectory? Considerations for when to screen for distress |
| title_sort | are breast cancer patients with low distress at diagnosis at risk of psychological symptoms later in their disease trajectory considerations for when to screen for distress |
| topic | Breast cancer cancer survivorship symptom trajectories psychological distress |
| url | https://medicaljournalssweden.se/actaoncologica/article/view/42367 |
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