Post-traumatic stress not more common in young vs older breast cancer survivors

Despite a higher risk for distress, breast cancer survivors who had been diagnosed at a young age show similar rates of cancer-related post-traumatic stress symptoms (PTSS) to the general breast cancer population, a new study has shown.

The study drew data of 700 breast cancer patients enrolled in the Young Women’s Breast Cancer Study. All patients were diagnosed at age ≤40 years. PTSS was defined as scoring ≥50 in the post-traumatic stress disorder checklist-specific version (PCL-S). Other psychosocial measures included social support, anxiety and depression, and fear of recurrence.

Majority had early-stage disease and were diagnosed with either stage 1 (39 percent) or 2 (47 percent) breast cancer. All received surgical treatment, and most (81 percent) underwent chemotherapy (81 percent) and radiation therapy (65 percent). Around 2 percent reported psychiatric comorbidities at baseline.

At a PCL-S cut-off of 50, 44 participants were found to have PTSS secondary to cancer and treatment, detected 30 months after diagnosis. This yielded a prevalence rate of 6.3 percent.

In multivariable analysis, anxiety (odds ratio [OR], 12.43, 95 percent confidence interval [CI], 5.81–26.59; p<0.0001) and stage 2 disease (vs stage 1: OR, 2.26, 95 percent CI, 1.04–4.93; p=0.04) emerged as significant risk factors for PTSS. Social support, on the other hand, was significantly protective (OR, 0.44, 95 percent CI, 0.13–0.94; p=0.03).

“Medical providers should be mindful of these risk factors in their initial assessment of young women with breast cancer, and should reassess these through active treatment and survivorship,” researchers said.

“Early identification of those at risk could facilitate individualized screening strategies for the development of PTSS, as well as targeted medical interventions to improve mental health and quality of life of breast cancer survivors diagnosed at a young age,” they added.