Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada.
Support Care Cancer. 2020 May;28(5):2247-2254. doi: 10.1007/s00520-019-05034-2. Epub 2019 Aug 26.
Despite having an excellent prognosis, patients with ductal carcinoma in situ (DCIS) report significant anxiety and depression following diagnosis. This study evaluated psychological morbidity using the Edmonton Symptom Assessment Scale (ESAS) in patients with DCIS compared with women with early-stage invasive breast cancer (EIBC) receiving radiotherapy (RT).
We identified patients diagnosed with DCIS or EIBC (stage I or II breast cancer) from 2011 to 2017 who had at least one ESAS completed pre- and post-RT. Data on systemic treatment, radiation, patient demographics, and disease stage were extracted from existing databases. Psychological morbidity was evaluated through measurement of depression, anxiety, and overall wellbeing within the ESAS. The Wilcoxon rank-sum test or chi-square test was performed for continuous or categorical variables.
This study included 137 women with DCIS and 963 women with EIBC. ESAS was completed on average 28 days before RT (baseline) and 142 days after RT. Baseline ESAS scores showed significantly higher rates of depression among women with EIBC compared with those with DCIS (p = 0.006). Patients with EIBC also reported higher levels of anxiety and lower overall wellbeing than patients with DCIS, but this difference was not statistically significant. Post-RT ESAS scores showed significantly higher anxiety in patients with EIBC compared with DCIS (p = 0.049). Post-RT measures of anxiety and overall wellbeing were higher in patients with EIBC but differences were not statistically significant.
Women with DCIS experience relatively less psychological morbidity than women with EIBC, pre- and post-RT.
尽管导管原位癌（DCIS）患者预后良好，但他们在诊断后仍会出现明显的焦虑和抑郁。本研究通过埃德蒙顿症状评估量表（ESAS）评估了 DCIS 患者的心理发病率，并与接受放疗（RT）的早期浸润性乳腺癌（EIBC）女性进行了比较。
我们从 2011 年至 2017 年期间确定了患有 DCIS 或 EIBC（I 期或 II 期乳腺癌）的患者，这些患者至少有一项 ESAS 在 RT 前后完成。从现有数据库中提取了关于全身治疗、放疗、患者人口统计学和疾病分期的数据。通过 ESAS 评估抑郁、焦虑和整体健康状况来评估心理发病率。采用 Wilcoxon 秩和检验或卡方检验比较连续或分类变量。
本研究纳入了 137 名 DCIS 患者和 963 名 EIBC 患者。ESAS 在 RT 前平均 28 天（基线）和 RT 后 142 天完成。基线 ESAS 评分显示，EIBC 患者的抑郁发生率明显高于 DCIS 患者（p=0.006）。与 DCIS 患者相比，EIBC 患者报告的焦虑水平更高，整体健康状况更低，但差异无统计学意义。RT 后 ESAS 评分显示，EIBC 患者的焦虑明显高于 DCIS 患者（p=0.049）。RT 后 EIBC 患者的焦虑和整体健康状况测量值较高，但差异无统计学意义。
在接受 RT 前后，DCIS 患者的心理发病率相对低于 EIBC 患者。
