Patients with breast cancer receiving adjuvant chemotherapy experience psychological distress, including anxiety and depression, and reduced quality of life during intermittent periods between treatment cycles, according to a study published in Cancer Nursing.

Although postsurgery adjuvant chemotherapy is a mainstay of therapy for patients with breast cancer, its low target specificity causes a multitude of side effects including fatigue, hair loss, and insomnia. Previous studies have shown that patients may experience anxiety and depression throughout treatment.

For this longitudinal study, researchers assessed the outcomes of 88 postoperative patients with breast cancer. Eligible patients were scheduled to initiate 6 cycles of cyclophosphamide, epirubicin, plus fluorouracil, and had no other major mental or medical disease. Patients completed the Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), and Functional Assessment of Cancer Therapy-Breast (FACT-B) on the first day of each cycle (T1-T5).

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Results showed that SAS and SDS scores ranged from 44.76±6.78 to 69.18±4.88 and 47.14±6.45 to 67.98±2.52 points, respectively, throughout the course of the CT sessions. The FACT-B scores ranged from 51.69±6.09 to 74.57±10.31.

The SAS, SDS, and FACT-B scores significantly differed between each of the 5 intermittent periods (P <.00), and the highest proportion of patients experienced severe anxiety and depression symptoms, along with the greatest reduction in quality of life, during T3.

The authors concluded that “clinical staff should focus on critical time periods during [chemotherapy], particularly during the third cycle, and provide additional support to patients to ensure that CT is delivered in an optimal fashion.”


Zhang J, Zhou Y, Feng Z, Xu Y, Zeng G. Longitudinal trends in anxiety, depression, and quality of life during different intermittent periods of adjuvant breast cancer chemotherapy