Anxiety and depression (Practice Point)
Diagnose and treat anxiety and depression in patients with breast cancer the same way as in the general population, noting that anxiety and depression reduce an individual’s ability to cope with disease and treatment burden. Be aware that menopausal symptoms and anxiety and depression are interconnected: treatment of menopausal symptoms may improve anxiety and depression (particularly via the resolution of sleep disturbance), while treatment of anxiety and depression may improve an individual’s ability to cope with menopausal symptoms.
How this guidance was developed
No evidence-based source recommendation was identified for this topic, which was considered an important aspect of care. This practice point was developed using an expert consensus process.
Fear of recurrence (Practice Point)
Ask patients if they are worried about the cancer recurring. Assess whether these worries are having a significant impact on their life and if so, offer referral to a psychologist.
How this guidance was developed
No evidence-based source recommendation was identified for this topic, which was considered an important aspect of care. This practice point was developed using a consensus process, informed by an ungraded recommendation in the Alberta Health Services 2015 (Canada) guidelines.
Return to work – Caring duties support (Practice Point)
Be aware that returning to work or caring duties after breast cancer treatment is often a challenge and that extra professional support may be needed (e.g. psychological services).
How this guidance was developed
No evidence-based source recommendation was identified for this topic, which was considered an important aspect of care. This practice point was developed using an expert consensus process, and was informed by a Cochrane review (de Boer et al. 2015) indicating moderate quality evidence showed multidisciplinary interventions involving physical, psycho-educational and/or vocational components lead to higher return-to-work rates than care as usual; and recommending referral to cancer rehabilitation services.
Return to work – Vocational rehabilitation (Practice Point)
For patients contemplating returning to work, consider referral for vocational rehabilitation programs where available
How this guidance was developed
No evidence-based source recommendation was identified for this topic, which was considered an important aspect of care. This practice point was developed using an expert consensus process and was informed by a Cochrane review (de Boer et al. 2015) recommending referral to cancer rehabilitation services.
