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PTSD symptoms not uncommon during breast cancer

Tuesday March 5, 2013
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Nearly one in four women newly diagnosed with breast cancer report symptoms consistent with post-traumatic stress disorder, according to a study.

The risk is more than 50% higher among black and Asian women, reported researchers at the Herbert Irving Comprehensive Cancer Center at NewYork Presbyterian/Columbia University Medical Center.

"This study is one of the first to evaluate the course of PTSD after a diagnosis of breast cancer," Alfred I. Neugut, MD, PhD, the study’s lead author and a member of the HICCC, said in a news release.

The 1,139 research participants were part of the Breast Cancer Quality of Care Study. Between 2006 and 2010, women with newly diagnosed breast cancer, stages I to III, and over age 20 were recruited from NewYork-Presbyterian/Columbia University Medical Center and Mount Sinai School of Medicine in New York City; the Henry Ford Health System in Detroit; and Kaiser-Permanente in Northern California. Each participant completed a phone interview two to three months after diagnosis and before the third chemotherapy cycle (if the patient was receiving chemotherapy), with follow-up phone interviews at four months and at six months after diagnosis.

Of 1,139 participants, the researchers wrote in an online-first article in the Journal of the National Cancer Institute, 23% reported symptoms consistent with a diagnosis of PTSD during the initial interview. The rate reporting PTSD symptoms was 16.5% during the second interview and 12.6% during the third.

Persistent PTSD, defined as having the condition during two consecutive interviews, was observed among 12.1% of participants. Among participants without PTSD during the first interview, 6.6% developed PTSD at the first follow-up interview.

Younger age at diagnosis, being black and being Asian were associated with higher risks of PTSD.

"The ultimate outcome of this research is to find ways to improve the quality of patients’ lives," said Neugut, the Myron M. Studner Professor of Cancer Research and professor of medicine and epidemiology at Columbia University’s College of Physicians & Surgeon and the Mailman School of Public Health. "If we can identify potential risk factors for PTSD, when women are diagnosed with breast cancer, we could provide early prevention and intervention to minimize PTSD symptoms. This approach might also have an indirect impact on the observed racial disparity in breast cancer survival."

The research team believes that these findings may apply to patients with other cancer diagnoses as well. Neugut, also an oncologist at NewYork Presbyterian/Columbia, noted that in previous research, symptoms of PTSD have been reported following prostate cancer and lymphoma diagnoses.

The study abstract is available at http://jnci.oxfordjournals.org/content/early/2013/02/21/jnci.djt024.abstract.


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