Women at a Dangerous Intersection: Diagnosis and Treatment of Depression and Related Disorders in Patients with Breast Cancer

Breast cancer is a relatively common diagnosis for American women and depressive symptoms occur in many women with breast cancer. Identification of women with breast cancer and concomitant depressive symptoms and mood disorders requires particular attention by heath care providers, and may be aided by the administration of a variety of diagnostic and/or screening tools. Insomnia is also a significant problem for women with breast cancer at various stages of diagnosis and treatment, including after remission. Although many studies on the treatment of depression in women with breast cancer have been done, and the data do point to the efficacy of several antidepressants in this population, there are no data to support the widely held hypothesis that treatment of depression in patients with breast cancer may positively affect morbidity and mortality. Breast cancer treatments may give rise to depressive symptoms and this should be considered in the approach to pharmacotherapy. Several psychotherapeutic modalities offer relief of the symptoms and syndromes of depression in breast cancer. Future research can answer the question of which approach is most appropriate for which patients, and whether therapy can improve a variety of health outcomes and survival for women with breast cancer.