To analyze the mental health of female breast cancer patients after modified radical mastectomy and explore its relationship with personality.

In this cross-sectional study, 132 female patients who underwent modified radical mastectomy for breast cancer and rechecking in clinic or in-patient units of the Department of Breast and Thyroid Surgery, the First Affiliated Hospital of Army Medical University were enrolled. The Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale-24 (HAMD-24) were used to investigate the anxiety and depression of all patients. The Functional Assessment of Cancer Therapy-Breast (FACT-B) was adopted to evaluate postoperative quality of life and the Ten-Item Personality Inventory-Chinese version (TIPI-C) was used to assess the personality of patients. Spearman correlation analysis was used to explore the correlation between the HAMA and HAMD-24 scores of female patients after breast cancer surgery and their age, postoperative time and education. The Mann-Whitney U test was used to compare the scores of four scales between patients ≤50 years and patients > 50 years. Multiple linear regression analysis was used to investigate the influence of each factor of life quality and personality on HAMA and HAMD-24 scores. The influence of personality factors on quality of life was also analyzed by multiple linear regression.

The patients were (48 ± 9) years old (range: 32-69 years). The postoperative course was (5±2) months (range: 1-12 months). Among 132 patients, 130 presented anxiety (HAMA score ≥ 7), accounting for 98.5%, and 111 had depression (HAMD-24 score ≥ 7), accounting for 84.1%. Anxiety was negatively correlated with patient age (r=-0.244, P=0.005) and course of disease (r=-0.313, P<0.001). There was a statistically significant difference in the HAMA score, additional attention section of FACT-B and the openness of TIPI-C between patients ≤50 years and patients > 50 years (Z=-3.142、-2.794、-2.286, all P<0.050). The influencing factors of anxiety in breast cancer patients after surgery included emotional well-being (B=-1.986, 95%CI: -3.158--0.814, t=-3.354, P=0.001), physical well-being (B=-1.765, 95%CI: -2.853--0.678, t=-3.211, P=0.002), openness (B=-0.510, 95%CI: -0.769--0.223, t=3.515, P=0.001), neuroticism (B=-0.425, 95%CI: -0.804--0.046, t=-2.219, P=0.028). The influencing factors of depression include emotional well-being (B=-4.123, 95%CI: -5.272--2.974, t=-7.099, P<0.001) and physical well-being (B=-2.553, 95%CI: -3.762--1.345, t=-4.179, P<0.001). Among the factors of personality, extroversion (B=0.469, 95%CI: 0.350-0.589, t=7.752, P<0.001), neuroticism (B=-0.654, 95%CI: -0.823--0.485, t=-7.671, P<0.001) and conscientiousness (B=0.545, 95%CI: 0.364-0.726, t=5.965, P<0.001) affected the quality of life after surgery.

The female breast cancer patients after modified radical mastectomy show a high detection rate of anxiety and depression. Personality traits may have an impact on their postoperative emotional state and quality of life. Clinicians can give psychological intervention according to the patients’ personality and postoperative mental state.