Anxiety and depression in breast cancer patients at start of adjuvant radiotherapy. Relations to age and type of surgery.

Using a self-report questionnaire, the Hospital Anxiety and Depression (HAD) scale, feelings of anxiety and depression were assessed in 133 breast cancer patients referred for adjuvant radiotherapy following surgical treatment. Eighteen patients (14%) had scores indicating morbid anxiety. Significant depression was recorded for only 2 patients (1.5%). Severe anxiety was recorded for 10 out of 54 mastectomized patients (19%) and for 8 out of 79 patients treated with breast conserving surgery (10%). The difference was not significant (p = 0.13). In a subgroup aged 50-59 years, morbid anxiety was significantly more common among mastectomized patients than among patients operated conservatively, 4 out of 9 (44%) vs. 1 out of 23 (4%) (p = 0.01). Such a pattern was not discernable in the patients < 50 years of age or those > or = 60 years old. The results suggest that, at start of adjuvant radiotherapy, emotional distress is characterized by anxiety rather than depression and the risk of morbid anxiety is especially large for mastectomized women in their fifties.