A recent Rutgers School of Public Health study has found that elderly patients with breast cancer and mental illness face an increased risk of death. Breast cancer is the most commonly diagnosed form of cancer among women in the United States and is a significant cause of death. When compared to the general population, individuals with mental illness face higher rates of overall mortality. Previous studies have not addressed the impact of preexisting mental illness on breast-cancer survival, particularly in the elderly, who have the highest rates of breast cancer.
[Photo: Ms. Kristy Iglay]
The study, led by Rutgers School of Public Health alumni, Ms. Kristy Iglay and Ms. Melissa Santorelli, along with colleagues from the Rutgers School of Public Health, the Rutgers Cancer Institute, and the Rutgers Robert Wood Johnson Medical School, examined the impact of severe mental illness on breast cancer death in elderly patients. The study included 16,636 Medicare-enrolled breast cancer patients from the United States. The authors compared breast cancer patients with and without mental illness to look at differences in breast cancer diagnosis and breast cancer treatment delays. They found that breast cancer patients with severe mental illness (bipolar disorder, schizophrenia, other psychotic disorders) had an increased risk of delaying their initial treatment for breast cancer after receiving a diagnosis. Breast cancer patients that had both anxiety and depression were more likely to experience a delay in being diagnosed with breast cancer once symptoms were noticed. The authors concluded that psychiatrists, primary care physicians, and oncologists should work together to make sure that patients with mental illness receive a timely diagnosis and adequate care for breast cancer.
“Primary care physicians must place an emphasis on early detection among women with severe mental illness to improve the likelihood of screening and treating,” according to the authors. “An understanding of how factors such as care use and quality and treatment decisions influence outcomes in this vulnerable population can help to inform changes in clinical practice.”
“Impact of Preexisting Mental Illness on All-Cause and Breast Cancer–Specific Mortality in Elderly Patients With Breast Cancer” was published in the Journal of Clinical Oncology.