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Anxiety, Depression in Women at High Risk for Breast Cancer

Anxiety, Depression in Women at High Risk for Breast Cancer

WASHINGTON—A substantial minority of the women who see themselves as being
at high risk for breast cancer because of family history suffer noticeable
depressive symptoms and anxiety, and the anxiety can interfere with compliance
with recommendations on breast self-examination (BSE), according to studies at
the UCLA Revlon Breast Center.

Nangel Lindberg, PhD, of the Revlon Breast Center, and David Wellisch, PhD,
professor in residence and chief psychologist for the Adult Services Division
of the UCLA Medical School Department of Psychiatry, reported findings on 430
patients attending the Revlon Center’s high-risk breast clinic. They spoke at
the American Psychological Association Conference on Enhancing Outcomes in
Women’s Health.

"It’s not enough to present information about cancer and risk to such
women," Dr. Wellisch said. "The anxiety must be managed."
Depression, however, does not appear to affect compliance in these women.

Women are selected to attend the multidisciplinary clinic mostly because of
elevated familial risk, and the clinic staff is "trying to assemble a
basic literature on the psychosocial features" of this population, Dr.
Wellisch explained.

Initial intake includes psychological screening tests and questionnaires
about familial breast cancer history and the women’s demographic
characteristics. In this study, 88% of the patients had first-degree relatives
with breast cancer—their mothers in 71% of cases, a sister in 16%, and both
in 13%. Two affected relatives is the average, but 28% of the women had three
or more; one woman had 26.

Five percent lacked a familial history of breast cancer but had precancerous
breast changes such as lobular carcinoma in situ, and 6% had both a family
history and breast changes.

The women ranged in age from 15 to 78. Eighty-four percent were white, 73%
had college or graduate education, and nearly all were of high socioeconomic
status.

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