Kim Min-Su, Kim So Young, Kim Jin-Hwan, Park Bumjung, Choi Hyo Geun
Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Seoul, Korea.
PLoS One. 2017 Apr 10;12(4):e0175395. doi: 10.1371/journal.pone.0175395. eCollection 2017.
The objective of this study was to compare the incidence of post-operative depression in breast cancer patients who have undergone mastectomy with the incidence of post-operative depression in non-breast cancer participants (controls).
Using data from the Korean Health Insurance Review and Assessment Service (HIRA), we selected 2,130 patients with breast cancer who have undergone mastectomy for this national cohort study and matched these patients 1:4 with 8,520 control participants according to age, sex, income, region, and pre-operative depression. The incidence of post-operative depression was measured from mastectomy year to post-op year 10. The Mann-Whitney U test was used for data analysis, and the false-discovery rate was applied to determine statistical significance (P < 0.05).
The incidence of depression was higher in the breast cancer with mastectomy group than in the control group up to 3 years after mastectomy). However, there was no difference in the incidence of depression between the breast cancer with mastectomy group and the control group after post-op 4 years. The incidence of depression was higher in the breast cancer with mastectomy group than in the control group up to 2 years after mastectomy, and there was no difference in the incidence of depression between the two groups after post-op 3 years in middle-aged and older adults (≥ 40 years old). In young adults (≤ 39 years old), the incidence of depression was significantly higher in the breast cancer with mastectomy group than in the control group in mastectomy year.
Patients undergoing mastectomy for breast cancer experience depression more frequently than healthy people. However, patients overcome their depressive mood symptoms during the postoperative period. Young adults overcome their symptoms more quickly than middle-aged and older adults.
本研究的目的是比较接受乳房切除术的乳腺癌患者术后抑郁症的发病率与非乳腺癌参与者（对照组）术后抑郁症的发病率。
利用韩国健康保险审查和评估服务机构（HIRA）的数据，我们为这项全国队列研究选取了2130例接受乳房切除术的乳腺癌患者，并根据年龄、性别、收入、地区和术前抑郁症情况，将这些患者与8520名对照参与者按1:4的比例进行匹配。从乳房切除术后一年到术后10年测量术后抑郁症的发病率。采用曼-惠特尼U检验进行数据分析，并应用错误发现率来确定统计学意义（P<0.05）。
在乳房切除术后3年内，乳房切除术的乳腺癌组抑郁症发病率高于对照组。然而，术后4年后，乳房切除术的乳腺癌组和对照组之间抑郁症发病率没有差异。在中年及以上成年人（≥40岁）中，乳房切除术后2年内，乳房切除术的乳腺癌组抑郁症发病率高于对照组，术后3年后两组之间抑郁症发病率没有差异。在年轻人（≤39岁）中，乳房切除术的乳腺癌组在乳房切除当年抑郁症发病率显著高于对照组。
接受乳房切除术的乳腺癌患者比健康人更频繁地经历抑郁症。然而，患者在术后期间克服了他们的抑郁情绪症状。年轻人比中年及以上成年人更快地克服症状。
