Impact of depression on treatment response and survival among patients with breast cancer: A multi-institutional retrospective cohort study.

Authors

Weijia Kong, Zining He, Daojuan Li, Jie Li

Published in

Breast (Edinburgh, Scotland). Volume 89. Pages 104862. Jul 03, 2026. Epub Jul 03, 2026.

Abstract

This study aims to investigate the relationship between depression and the risks of breast cancer recurrence and mortality.
This retrospective cohort study included 2667 breast cancer patients hospitalized across four hospitals in China between January 1, 2016, and December 31, 2019, with follow-up until December 31, 2025. We identified patients diagnosed with depressive disorder and collected demographic characteristics, tumor pathological features, and clinical treatment data. Primary outcomes were recurrence and mortality. Multi-variable Cox proportional hazards models were used, adjusting for age, tumor stage, estrogen receptor (ER)/progesterone receptor (PR)/human epidermal growth factor receptor-2 (HER2) status, chemoradiotherapy, surgical method, marital status, and body mass index (BMI).
Among 2667 breast cancer patients, 343 (12.8%) were diagnosed with depression disorder. Multivariable analysis showed depressed patients had 60% higher recurrence risk (HR = 1.60, 95% CI:1.21-2.13) and 70% higher breast cancer-specific mortality risk (HR = 1.70, 95% CI:1.20-2.41). In all ER/PR subgroups, depression consistently increased risks (HR > 1), particularly in HER2-positive patients. A significant interaction existed between radiotherapy and depression on mortality (p =0.017), with elevated risk more evident in patients who received radiotherapy. Across all surgical types, depressed patients consistently showed higher risks.
Breast cancer patients with comorbid depression tend to have inferior clinical outcomes. Future research should explore the underlying mechanisms linking depression to cancer progression and evaluate targeted interventions.

PMID:
42419252
Bibliographic data and abstract were imported from PubMed on 09 Jul 2026.

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