Effect Of Different Order Of Operation And Chemotherapy On Anxiety And Depression Of Breast Cancer Patients

Objective: To explore the effect of different orders of operation and chemotherapy on anxiety and depression in breast cancer patients.Methods: This study prospectively included the patients diagnosed with breast cancer who underwent surgery and chemotherapy at Zhongda Hospital Southeast University from September 2020 to December 2021.Patients were divided into the surgery-first group(adjuvant chemotherapy after radical surgery for breast cancer)and the chemotherapy-first group(radical surgery after neoadjuvant chemotherapy for breast cancer).All the patients received the two treatment stages,which one is surgery and another is chemotherapy.In the process of treatment,the GAD-7 and PHQ-9 scale were used to assess the patients’ anxiety and depression on admission,before the first stage,after the first stage,before the second stage and after the second stage.Then the scores of two groups of patients were compared to assess whether surgery and chemotherapy treatments order will effect the patients mood.T test was used for measurement data conforming to normal distribution,non-parametric rank-sum test was used for measurement data not conforming to normal distribution,chi-square test or Fisher’s exact probability method was used for counting data,P < 0.05 was considered as significant difference.Results: There were 69 patients included in this study,44 patients in the surgery-first group and 25 patients in the chemotherapy-first group.On admission,23 patients(33.33%)were depressed,and 25 patients(36.23%)were anxious.In terms of depression,the score after the first-stage treatment in the surgery-first group was statistically different from that on other time points.In the chemotherapy-first group,there was no significant difference at all five time points.There was a significant difference in depression scores between the two groups(Z=-3.296,P=0.001)in the surgery group after surgery and after chemotherapy in the chemotherapy-first group.In terms of anxiety,the surgery-first group was anxious after the first stage of treatment and after the second stage of treatment.The scores were significantly different from anxiety scores at other time points.In the chemotherapy-first group,the anxiety scores before the first –stage treatment were statistically different from those before and after the second-stage treatment.There was a difference in anxiety scores between the two groups before the second-stage(Z=-2.762,P=0.006).Multiple linear regression analysis showed that the difference in anxiety and depression scores between the two goups was caused by different treatment groups.Conclusions: The different implementation sequence of surgery and chemotherapy has an impact on the changes of anxiety and depression in breast cancer patients during treatment,but no matter which treatment plan,there is no difference in anxiety and depression of patients before and after complete treatment.The completion of surgery can relieve the anxiety and depression of patients,mainly manifested as the scores of anxiety and depression of patients decreased significantly after surgery,and the level of anxiety and depression after chemotherapy was higher than before,so the chemotherapy will cause the aggravation of anxiety and depression level.Therefore,the doctors should assess the patients be in the process of treatment of with anxiety depression,and give the explanation about the disease,the treatment and the side-effects when the level of depression and anxiety is high,even give the treatment to depression and anxiety when necessary,to reduce the patients fear of disease or treatment to slow patients’ anxiety and depression,Enable the patient to successfully complete the original treatment plan.