Abstract
Background
To carry out a systematic review and meta-analysis of the literature to determine whether different type of surgery induces different depression occurrence in female breast cancer at mean time more than 1-year term postoperatively.
Methods
A systematic literature search of PubMed, Web of Science, EMBASE, OvidSP, EBSCO and PsycARTICLES was conducted. Observational clinical studies that compared the depression incidence in different surgery groups and presented empirical findings were selected.
Results
Sixteen studies met the inclusion criteria, including 5, 4, 2 and 5 studies compared depression between total mastectomy (TM) and breast conserving therapy (BCS), TM and breast reconstruction (BR), BCS and BR, or among all three groups (TM, BCS and BR), respectively. Only 1 of 5 studies, which subjected to multivariate analysis of depression in female breast cancer, reported a statistically significant effect of type of surgery on depression occurrence. Our meta-analysis showed no significant differences among the three types of surgery, with BCS patients versus TM patients (relative risk [RR] = 0.89, 95% confidence interval [CI] 0.78–1.01; P = 0.06), BR patients versus TM patients (RR = 0.87, 95% CI 0.71–1.06; P = 0.16) and BCS patients versus BR patients (RR = 1.10; 95% CI 0.89–1.35; P = 0.37), respectively.
Conclusions
Our study showed that there were no statistically significant differences concerning the occurrence of depressive symptoms in breast cancer patients as a consequence of TM, BCS or BR at mean time more than 1-year term postoperatively.
Similar content being viewed by others
Change history
26 March 2018
The following grant funding information was omitted from the original article.
References
Siegel RL, Miller KD, Jemal A (2016) Cancer statistics. CA Cancer J Clin 66:7–30
Runowicz CD, Leach CR, Henry NL et al (2016) American cancer society/American society of clinical oncology breast cancer survivorship care guideline. J Clin Oncol 34:611–635
Zainal NZ, Nik-Jaafar NR, Baharudin A et al (2013) Prevalence of depression in breast cancer survivors: a systematic review of observational studies. Asian Pac J Cancer Prev 14:2649–2656
Yilmazer N, Aydiner A, Ozkan S et al (1994) A comparison of body image, self-esteem and social support in total mastectomy and breast-conserving therapy in Turkish women. Support Care Cancer 2:238–241
Khan S, Khan NA, Rehman AU et al (2016) Levels of depression and anxiety post-mastectomy in breast cancer patients at a public sector hospital in Karachi. Asian Pac J Cancer Prev 17:1337–1340
Moyer A (1997) Psychosocial outcomes of breast-conserving surgery versus mastectomy: a meta-analytic review. Health Psychol 16:284–298
Monteiro-Grillo I, Marques-Vidal P, Jorge M (2005) Psychosocial effect of mastectomy versus conservative surgery in patients with early breast cancer. Clin Transl Oncol 7:499–503
Ganz PA, Kwan L, Stanton AL et al (2004) Quality of life at the end of primary treatment of breast cancer: first results from the moving beyond cancer randomized trial. J Natl Cancer Inst 96:376–387
Golden-Kreutz DM, Andersen BL (2004) Depressive symptoms after breast cancer surgery: relationships with global, cancer-related, and life event stress. Psychooncology 13:211–220
Den Oudsten BL, Van Heck GL, der Steeg Van et al (2009) Predictors of depressive symptoms 12 months after surgical treatment of early-stage breast cancer. Psychooncology 18:1230–1237
Sun MQ, Meng AF, Huang XE et al (2013) Comparison of psychological influence on breast cancer patients between breast-conserving surgery and modified radical mastectomy. Asian Pac J Cancer Prev 14:149–152
Fisher B, Anderson S, Bryant J et al (2002) Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 347:1233–1241
Teimourian B, Adham MN (1982) Survey of patients’ responses to breast reconstruction. Ann Plast Surg 9:321–325
Fernandez-Delgado J, Lopez-Pedraza MJ, Blasco JA et al (2008) Satisfaction with and psychological impact of immediate and deferred breast reconstruction. Ann Oncol 19:1430–1434
Nicholson RM, Leinster S, Sassoon EM (2007) A comparison of the cosmetic and psychological outcome of breast reconstruction, breast conserving surgery and mastectomy without reconstruction. Breast 16:396–410
de Raaff CA, Derks EA, Torensma B et al (2016) Breast reconstruction after mastectomy: does it decrease depression at the long-term? Gland Surg 5:377–384
Harcourt DM, Rumsey NJ, Ambler NR et al (2003) The psychological effect of mastectomy with or without breast reconstruction: a prospective, multicenter study. Plast Reconstr Surg 111:1060–1068
Rowland JH, Desmond KA, Meyerowitz BE et al (2000) Role of breast reconstructive surgery in physical and emotional outcomes among breast cancer survivors. J Natl Cancer Inst 92:1422–1429
Medeiros MC, Veiga DF, Sabino Neto M et al (2010) Depression and conservative surgery for breast cancer. Clinics (Sao Paulo) 65:1291–1294
Sackey H, Sandelin K, Frisell J et al (2010) Ductal carcinoma in situ of the breast. Long-term follow-up of health-related quality of life, emotional reactions and body image. Eur J Surg Oncol 36:756–762
Moher D, Liberati A, Tetzlaff J et al (2010) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg 8:336–341
Liberati A, Altman DG, Tetzlaff J et al (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol 62:e1–e34
Castillo JJ, Dalia S, Pascual SK (2010) Association between red blood cell transfusions and development of non-Hodgkin lymphoma: a meta-analysis of observational studies. Blood 116:2897–2907
Stang A (2010) Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol 25:603–605
Langan D, Higgins JPT, Gregory W et al (2012) Graphical augmentations to the funnel plot assess the impact of additional evidence on a meta-analysis. J Clin Epidemiol 65:511–519
Lau J, Ioannidis JPA, Terrin N et al (2006) The case of the misleading funnel plot. BMJ 333:597–600
Sun Y, Kim SW, Heo CY et al (2014) Comparison of quality of life based on surgical technique in patients with breast cancer. Jpn J Clin Oncol 44:22–27
Fang SY, Chang HT, Shu BC (2014) Objectified body consciousness, body image discomfort, and depressive symptoms among breast cancer survivors in taiwan. Psychol Women Q 38:563–574
Eltahir Y, Werners LL, Dreise MM et al (2013) Quality-of-life outcomes between mastectomy alone and breast reconstruction: comparison of patient-reported BREAST-Q and other health-related quality-of-life measures. Plast Reconstr Surg 132:201e–209e
Qiu J, Yang M, Chen W et al (2012) Prevalence and correlates of major depressive disorder in breast cancer survivors in Shanghai, China. Psychooncology 21:1331–1337
Dastan NB, Buzlu S (2011) Depression and anxiety levels in early stage Turkish breast cancer patients and related factors. Asian Pac J Cancer Prev 12:137–141
Chen X, Zheng Y, Zheng W et al (2009) Prevalence of depression and its related factors among Chinese women with breast cancer. Acta Oncol 48:1128–1136
Kim SH, Son BH, Hwang SY et al (2008) Fatigue and depression in disease-free breast cancer survivors: prevalence, correlates, and association with quality of life. J Pain Symptom Manag 35:644–655
Parker PA, Youssef A, Walker S et al (2007) Short-term and long-term psychosocial adjustment and quality of life in women undergoing different surgical procedures for breast cancer. Ann Surg Oncol 14:3078–3089
Rubino C, Figus A, Lorettu L et al (2007) Post-mastectomy reconstruction: a comparative analysis on psychosocial and psychopathological outcomes. J Plast Reconstr Aesthet Surg 60:509–518
Al-Ghazal SK, Fallowfield L, Blamey RW (2000) Comparison of psychological aspects and patient satisfaction following breast conserving surgery, simple mastectomy and breast reconstruction. Eur J Cancer 36:1938–1943
Waljee JF, Hu ES, Ubel PA et al (2008) Effect of esthetic outcome after breast-conserving surgery on psychosocial functioning and quality of life. J Clin Oncol 26:3331–3337
Cellini C, Huston TL, Martins D et al (2005) Multiple re-excisions versus mastectomy in patients with persistent residual disease following breast conservation surgery. Am J Surg 189:662–666
Wilkins EG, Cederna PS, Lowery JC et al (2000) Prospective analysis of psychosocial outcomes in breast reconstruction: one-year postoperative results from the Michigan Breast Reconstruction Outcome Study. Plast Reconstr Surg 106:1014–1025; discussion 1026–1017
Bellino S, Fenocchio M, Zizza M et al (2011) Quality of life of patients who undergo breast reconstruction after mastectomy: effects of personality characteristics. Plast Reconstr Surg 127:10–17
Alexander S, Palmer C, Stone PC (2010) Evaluation of screening instruments for depression and anxiety in breast cancer survivors. Breast Cancer Res Treat 122:573–578
Callari A, Mauri M, Miniati M et al (2013) Treatment of depression in patients with breast cancer: a critical review. Tumori 99:623–633
Rijken M, de Kruif AT, Komproe IH et al (1995) Depressive symptomatology of post-menopausal breast cancer patients: a comparison of women recently treated by mastectomy or by breast-conserving therapy. Eur J Surg Oncol 21:498–503
Vahdaninia M, Omidvari S, Montazeri A (2010) What do predict anxiety and depression in breast cancer patients? A follow-up study. Soc Psychiatry Psychiatr Epidemiol 45:355–361
Ewertz M, Jensen AB (2011) Late effects of breast cancer treatment and potentials for rehabilitation. Acta Oncol 50:187–193
Bardwell WA, Natarajan L, Dimsdale JE et al (2006) Objective cancer-related variables are not associated with depressive symptoms in women treated for early-stage breast cancer. J Clin Oncol 24:2420–2427
Christensen S, Zachariae R, Jensen AB et al (2009) Prevalence and risk of depressive symptoms 3–4 months post-surgery in a nationwide cohort study of Danish women treated for early stage breast-cancer. Breast Cancer Res Treat 113:339–355
Lam WW, Chan M, Ka HW et al (2007) Treatment decision difficulties and post-operative distress predict persistence of psychological morbidity in chinese women following breast cancer surgery. Psycho-oncology 16:904–912
Fann JR, Thomas-Rich AM, Katon WJ et al (2008) Major depression after breast cancer: a review of epidemiology and treatment. Gen Hosp Psychiatry 30:112–126
Matthews H, Grunfeld EA, Turner A (2016) The efficacy of interventions to improve psychosocial outcomes following surgical treatment for breast cancer: a systematic review and meta-analysis. Psychooncology 32:187–204
Acknowledgements
Grant support for the research reported: General Scientific Research foundation of Shanghai Mental Health Center Grants 2017-YJ-10; Youth Fundation of Zhongshan Hospital Grants 2016ZSQZ54.
Author information
Authors and Affiliations
Corresponding authors
Ethics declarations
Conflict of interest
The authors declare that there are no conflicts, either perceived or real, with respect to this article.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Zhang, C., Hu, G., Biskup, E. et al. Depression Induced by Total Mastectomy, Breast Conserving Surgery and Breast Reconstruction: A Systematic Review and Meta-analysis. World J Surg 42, 2076–2085 (2018). https://doi.org/10.1007/s00268-018-4477-1
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00268-018-4477-1