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Surgical impact on anxiety of patients with breast cancer: 12-month follow-up prospective longitudinal study

Annals of Surgical Treatment and Research 2020년 98권 5호 p.215 ~ 223
 ( Kim Ji-Young ) - Daerim St. Mary’s Hospital Department of Surgery

조주희 ( Cho Ju-Hee ) - Sungkyunkwan University School of Medicine Samsung Medical Center Samsung Comprehensive Cancer Center
이세경 ( Lee Se-Kyung ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery
최은경 ( Choi Eun-Kyung ) - Sungkyunkwan University School of Medicine Samsung Medical Center Cancer Education Center
김임령 ( Kim Im-Ryung ) - Sungkyunkwan University School of Medicine Samsung Medical Center Samsung Comprehensive Cancer Center
이정언 ( Lee Jeong-Eon ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery
김원석 ( Kim Seok-Won ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery
남석진 ( Nam Seok-Jin ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery

Abstract


Purpose: Breast cancer diagnosis and treatment often produce stress in patients. Anxiety is one of the most prevalent psychological symptoms perceived by breast cancer patients. This study aims to evaluate the temporal patterns of anxiety and find factors associated with persistent anxiety during breast cancer treatment.

Methods: This is prospective cohort study. Between July 2010 and July 2011, we recruited patients with nonmetastatic breast cancer who were expected to receive adjuvant chemotherapy (n = 411) from 2 cancer hospitals in Seoul, Korea. Anxiety was measured using the Hospital Anxiety and Depression Scale.

Results: The mean age of the participants was 46.4 ± 7.9 years. Preoperatively, 44.5% (183 of 411) of the patients showed abnormal anxiety. The proportion of the abnormal anxiety group significantly decreased after surgery (P < 0.01) and this phenomenon continued until the 12-month follow-up point. Patients experienced renewed anxiety at 12 months when the main adjuvant therapies were finished. Socioeconomic factors were not associated with persistent anxiety. Pain, breast, and arm symptoms were significantly higher in the persistently abnormal group, especially at postoperative months 6 and 12.

Conclusion: Surgery was a major relieving factor of anxiety, and patients who finished their main adjuvant treatment experienced renewed anxiety. Surgeons should be the main detectors and care-givers with respect to psychological distress in breast cancer patients. To reduce persistent anxiety, caring for the patient's physical symptoms is important.

키워드

Anxiety; Breast neoplasms; Perioperative period; Surgery
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