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Global prevalence and factors associated with preoperative depression in women undergoing breast surgery: a meta-analysis and meta-regression

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Abstract

Purpose

Depression is one of the main psychological responses experienced by patients with breast cancer perioperatively. Therefore, this review aimed to synthesize the prevalence rate of depression preoperatively among patients with breast cancer.

Methods

Six databases were searched for published articles, which recruited female patients aged 18 years and above, diagnosed with breast cancer and planned for breast surgery. Grey literatures were searched from ProQuest Theses and Dissertations, Science.gov and CogPrints. Studies published in English from the inception of databases to January 2023 were considered. Two reviewers screened, extracted, and appraised the data independently. Joanna Briggs Institute data collection form was used for data collection. Hoy’s Risk of Bias Tool was utilized to assess the individual study’s quality. Review Manager 5.4 software was utilized for meta-analysis. Subgroup analyses were conducted to explore the reasons for any heterogeneity. Publication bias was evaluated by Egger’s test and funnel plot.

Results

Twenty studies involving 32,143 patients with breast cancer were included. Meta-analyses revealed an overall preoperative prevalence of 30% among all studies. Subgroup analyses showed that studies conducted in the Middle East and North Africa used purposive sampling, with patients undergoing mastectomy and lumpectomy and with moderate risk of bias reported higher prevalence of preoperative depression (54%, 44%, 40%, and 49%, respectively) as compared to other respective subgroups.

Conclusion

The high prevalence of preoperative depression among women with breast cancer indicated the need for health care professionals to provide more psychological support to them.

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Data availability

Data related to this review, including data extracted from included studies, data used for all analyses, analytic code, and any other materials used in the review, can be found in the Supplementary material or provided upon request from the first or corresponding author.

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  1. Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Bock MD11, 10 Medical Drive, Singapore, 117597, Singapore

    Celest Su Yi Leo, Xin Rong Lam & Honggu He

  2. National University Health System, Singapore, Singapore

    Celest Su Yi Leo, Ling Jie Cheng, Xin Rong Lam & Honggu He

  3. Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore

    Ling Jie Cheng

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Leo, C.S.Y., Cheng, L.J., Lam, X.R. et al. Global prevalence and factors associated with preoperative depression in women undergoing breast surgery: a meta-analysis and meta-regression. Breast Cancer Res Treat (2024). https://doi.org/10.1007/s10549-023-07216-3

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