{"id":"https://openalex.org/W7225834306","doi":"https://doi.org/10.3389/fonc.2026.1996522","title":"Depressive symptoms are associated with poor prognosis and lower pathological complete response in triple-negative breast cancer: a single-center retrospective study","display_name":"Depressive symptoms are associated with poor prognosis and lower pathological complete response in triple-negative breast cancer: a single-center retrospective study","publication_year":2026,"publication_date":"2026-11-11","ids":{"openalex":"https://openalex.org/W7225834306","doi":"https://doi.org/10.3389/fonc.2026.1996522"},"language":"en","primary_location":{"id":"doi:10.3389/fonc.2026.1996522","doi":"https://doi.org/10.3389/fonc.2026.1996522","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fonc.2026.1996522","pdf_url":"https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2026.1996522/pdf","source":{"id":"https://openalex.org/S2596394214","display_name":"Frontiers in Oncology","issn_l":"2234-943X","issn":["2234-943X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Oncology","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2026.1996522/pdf","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5134756053","display_name":"Hailin Yang","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210129459","display_name":"The Affiliated Yongchuan Hospital of Chongqing Medical University","ror":"https://ror.org/033vnzz93","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210129459"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Hailin Yang","raw_affiliation_strings":["Department of Breast and Thyroid Surgery, Chongqing Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University","Department of Thoracic And Thyroid Breast Surgery, The People\u2019s Hospital of Yubei"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Breast and Thyroid Surgery, Chongqing Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University","institution_ids":["https://openalex.org/I4210129459"]},{"raw_affiliation_string":"Department of Thoracic And Thyroid Breast Surgery, The People\u2019s Hospital of Yubei","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5146521849","display_name":"Xuanyi Wang","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210129459","display_name":"The Affiliated Yongchuan Hospital of Chongqing Medical University","ror":"https://ror.org/033vnzz93","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210129459"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Xuanyi Wang","raw_affiliation_strings":["Department of Breast and Thyroid Surgery, Chongqing Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Breast and Thyroid Surgery, Chongqing Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University","institution_ids":["https://openalex.org/I4210129459"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5064526774","display_name":"Kunxia Chen","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210129459","display_name":"The Affiliated Yongchuan Hospital of Chongqing Medical University","ror":"https://ror.org/033vnzz93","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210129459"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Kunxia Chen","raw_affiliation_strings":["Department of Breast and Thyroid Surgery, Chongqing Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Breast and Thyroid Surgery, Chongqing Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University","institution_ids":["https://openalex.org/I4210129459"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5161428003","display_name":"Xiaolu Hu","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210129459","display_name":"The Affiliated Yongchuan Hospital of Chongqing Medical University","ror":"https://ror.org/033vnzz93","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210129459"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Xiaolu Hu","raw_affiliation_strings":["Department of Breast and Thyroid Surgery, Chongqing Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Breast and Thyroid Surgery, Chongqing Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University","institution_ids":["https://openalex.org/I4210129459"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5019012481","display_name":"Hanzhi Li","orcid":"https://orcid.org/0009-0004-9860-508X","observed_orcids":["https://orcid.org/0009-0004-9860-508X"]},"institutions":[{"id":"https://openalex.org/I4210129459","display_name":"The Affiliated Yongchuan Hospital of Chongqing Medical University","ror":"https://ror.org/033vnzz93","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210129459"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Hanzhi Li","raw_affiliation_strings":["Department of Breast and Thyroid Surgery, Chongqing Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Breast and Thyroid Surgery, Chongqing Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University","institution_ids":["https://openalex.org/I4210129459"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5161454632","display_name":"Lingfeng Tang","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210129459","display_name":"The Affiliated Yongchuan Hospital of Chongqing Medical University","ror":"https://ror.org/033vnzz93","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210129459"]}],"countries":["CN"],"is_corresponding":true,"raw_author_name":"Lingfeng Tang","raw_affiliation_strings":["Department of Breast and Thyroid Surgery, Chongqing Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Breast and Thyroid Surgery, Chongqing Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University","institution_ids":["https://openalex.org/I4210129459"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5161439504","display_name":"Shengchun Liu","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210129459","display_name":"The Affiliated Yongchuan Hospital of Chongqing Medical University","ror":"https://ror.org/033vnzz93","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210129459"]}],"countries":["CN"],"is_corresponding":true,"raw_author_name":"Shengchun Liu","raw_affiliation_strings":["Department of Breast and Thyroid Surgery, Chongqing Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Breast and Thyroid Surgery, Chongqing Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University","institution_ids":["https://openalex.org/I4210129459"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5161439504","https://openalex.org/A5161454632"],"corresponding_institution_ids":["https://openalex.org/I4210129459"],"apc_list":{"value":3150,"currency":"CHF","value_usd":3801},"apc_paid":{"value":3150,"currency":"CHF","value_usd":3801},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"16","issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10178","display_name":"Cancer survivorship and care","score":0.7656000256538391,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10178","display_name":"Cancer survivorship and care","score":0.7656000256538391,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10183","display_name":"Breast Cancer Treatment Studies","score":0.1931000053882599,"subfield":{"id":"https://openalex.org/subfields/1306","display_name":"Cancer Research"},"field":{"id":"https://openalex.org/fields/13","display_name":"Biochemistry, Genetics and Molecular Biology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},{"id":"https://openalex.org/T12626","display_name":"Cancer, Stress, Anesthesia, and Immune Response","score":0.026000000536441803,"subfield":{"id":"https://openalex.org/subfields/1306","display_name":"Cancer Research"},"field":{"id":"https://openalex.org/fields/13","display_name":"Biochemistry, Genetics and Molecular Biology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}}],"keywords":[],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8862000107765198},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.7613000273704529},{"id":"https://openalex.org/C530470458","wikidata":"https://www.wikidata.org/wiki/Q128581","display_name":"Breast cancer","level":3,"score":0.722599983215332},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.703499972820282},{"id":"https://openalex.org/C207886595","wikidata":"https://www.wikidata.org/wiki/Q1456138","display_name":"Pathological","level":2,"score":0.6187999844551086},{"id":"https://openalex.org/C207103383","wikidata":"https://www.wikidata.org/wiki/Q3930246","display_name":"Hazard ratio","level":3,"score":0.5717999935150146},{"id":"https://openalex.org/C50382708","wikidata":"https://www.wikidata.org/wiki/Q223218","display_name":"Proportional hazards model","level":2,"score":0.5659000277519226},{"id":"https://openalex.org/C143998085","wikidata":"https://www.wikidata.org/wiki/Q162555","display_name":"Oncology","level":1,"score":0.5616000294685364},{"id":"https://openalex.org/C151956035","wikidata":"https://www.wikidata.org/wiki/Q1132755","display_name":"Logistic regression","level":2,"score":0.5189999938011169},{"id":"https://openalex.org/C121608353","wikidata":"https://www.wikidata.org/wiki/Q12078","display_name":"Cancer","level":2,"score":0.498199999332428},{"id":"https://openalex.org/C2776867660","wikidata":"https://www.wikidata.org/wiki/Q1814941","display_name":"Depression (economics)","level":2,"score":0.4724000096321106},{"id":"https://openalex.org/C2776694085","wikidata":"https://www.wikidata.org/wiki/Q974135","display_name":"Chemotherapy","level":2,"score":0.43470001220703125},{"id":"https://openalex.org/C156957248","wikidata":"https://www.wikidata.org/wiki/Q1862216","display_name":"Odds ratio","level":2,"score":0.3953999876976013},{"id":"https://openalex.org/C3019096185","wikidata":"https://www.wikidata.org/wiki/Q1340863","display_name":"Complete response","level":3,"score":0.376800000667572},{"id":"https://openalex.org/C3019858935","wikidata":"https://www.wikidata.org/wiki/Q4340209","display_name":"Depressive symptoms","level":3,"score":0.33660000562667847},{"id":"https://openalex.org/C2778292576","wikidata":"https://www.wikidata.org/wiki/Q6991934","display_name":"Neoadjuvant therapy","level":4,"score":0.3287000060081482},{"id":"https://openalex.org/C205545832","wikidata":"https://www.wikidata.org/wiki/Q17156455","display_name":"Young adult","level":2,"score":0.314300000667572},{"id":"https://openalex.org/C10515644","wikidata":"https://www.wikidata.org/wiki/Q543310","display_name":"Survival analysis","level":2,"score":0.2915000021457672},{"id":"https://openalex.org/C3019894029","wikidata":"https://www.wikidata.org/wiki/Q332823","display_name":"Overall survival","level":2,"score":0.2802000045776367},{"id":"https://openalex.org/C201903717","wikidata":"https://www.wikidata.org/wiki/Q1778788","display_name":"Cohort study","level":2,"score":0.2800000011920929},{"id":"https://openalex.org/C2776283816","wikidata":"https://www.wikidata.org/wiki/Q332823","display_name":"Survival rate","level":2,"score":0.2777999937534332},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.26170000433921814}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.3389/fonc.2026.1996522","doi":"https://doi.org/10.3389/fonc.2026.1996522","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fonc.2026.1996522","pdf_url":"https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2026.1996522/pdf","source":{"id":"https://openalex.org/S2596394214","display_name":"Frontiers in Oncology","issn_l":"2234-943X","issn":["2234-943X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Oncology","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.3389/fonc.2026.1996522","doi":"https://doi.org/10.3389/fonc.2026.1996522","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fonc.2026.1996522","pdf_url":"https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2026.1996522/pdf","source":{"id":"https://openalex.org/S2596394214","display_name":"Frontiers in Oncology","issn_l":"2234-943X","issn":["2234-943X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Oncology","raw_type":"journal-article"},"sustainable_development_goals":[],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7225834306.pdf","grobid_xml":"https://content.openalex.org/works/W7225834306.grobid-xml"},"referenced_works_count":42,"referenced_works":["https://openalex.org/W1986400500","https://openalex.org/W1996048876","https://openalex.org/W2034701794","https://openalex.org/W2134539328","https://openalex.org/W2151356556","https://openalex.org/W2157285286","https://openalex.org/W2264908903","https://openalex.org/W2728962997","https://openalex.org/W2914453668","https://openalex.org/W2937440490","https://openalex.org/W3033869790","https://openalex.org/W3057125992","https://openalex.org/W3173809086","https://openalex.org/W3215863333","https://openalex.org/W3216651696","https://openalex.org/W4318303080","https://openalex.org/W4320490019","https://openalex.org/W4368618081","https://openalex.org/W4379533998","https://openalex.org/W4385623870","https://openalex.org/W4388575993","https://openalex.org/W4392130318","https://openalex.org/W4392499009","https://openalex.org/W4392757685","https://openalex.org/W4394685558","https://openalex.org/W4396952250","https://openalex.org/W4398780515","https://openalex.org/W4399478760","https://openalex.org/W4402035142","https://openalex.org/W4404297846","https://openalex.org/W4404333272","https://openalex.org/W4404556528","https://openalex.org/W4405137325","https://openalex.org/W4405543267","https://openalex.org/W4406968743","https://openalex.org/W4408129261","https://openalex.org/W4410042492","https://openalex.org/W4410434526","https://openalex.org/W4415243578","https://openalex.org/W4417065254","https://openalex.org/W7118745246","https://openalex.org/W7128443417"],"related_works":[],"abstract_inverted_index":{"Background":[0],"Depressive":[1],"symptoms":[2,122,210,248],"are":[3,297],"common":[4],"in":[5,17,127,187,193,257],"patients":[6,31,41,53,74,150],"with":[7,12,32,42,90,125,213,251,289],"cancer,":[8],"but":[9],"their":[10],"associations":[11],"survival":[13,162,174,253],"and":[14,38,61,95,129,132,170,254,264,293],"treatment":[15,266,295],"response":[16,81,92],"triple-negative":[18],"breast":[19,33,231],"cancer":[20,34,222,232],"(TNBC)":[21],"remain":[22],"uncertain.":[23],"Methods":[24],"This":[25],"single-center":[26],"retrospective":[27,259],"study":[28],"screened":[29],"19,335":[30],"treated":[35],"during":[36],"2015\u20132025":[37],"included":[39,72,84],"4,060":[40],"TNBC.":[43],"A":[44],"single":[45],"baseline":[46,76,120,137,152,246],"Patient":[47],"Health":[48],"Questionnaire-9":[49],"(PHQ-9)":[50],"assessment":[51],"classified":[52],"into":[54],"normal/mild":[55,195],"(score":[56,63],"<10;":[57],"n":[58,65],"=":[59,66,147,199,205,224,239],"3,666)":[60],"moderate/severe":[62,119,189],"\u226510;":[64],"394)":[67],"symptom":[68,291],"groups.":[69],"Survival":[70],"analyses":[71,83],"3,878":[73],"without":[75,151],"distant":[77,138,153],"metastasis;":[78],"pathological":[79],"complete":[80],"(pCR)":[82],"1,689":[85],"neoadjuvant":[86],"chemotherapy":[87],"(NACT)":[88],"recipients":[89],"available":[91],"data.":[93],"Cox":[94],"logistic":[96],"regression":[97],"models":[98],"adjusted":[99,155],"for":[100,160,172],"recorded":[101],"clinicopathological":[102],"variables.":[103],"An":[104],"exploratory":[105],"cross-sectional":[106],"analysis":[107],"of":[108,136,216,220,282],"NHANES":[109],"2009\u20132018":[110],"was":[111,185,234],"conducted":[112],"separately.":[113],"Results":[114],"In":[115,207],"the":[116,188,194,230,279],"TNBC":[117,260],"cohort,":[118],"depressive":[121,209,247],"were":[123,158,211,249],"associated":[124,212,250],"differences":[126],"T-stage":[128],"Ki-67":[130],"distributions":[131,141],"a":[133,217,275],"higher":[134,214],"frequency":[135],"metastasis.":[139],"N-stage":[140],"did":[142],"not":[143,235,273],"differ":[144],"significantly":[145],"(P":[146],"0.059).":[148],"Among":[149],"metastasis,":[154],"hazard":[156],"ratios":[157],"1.626":[159],"overall":[161],"(OS;":[163],"95%":[164,176,201,226,241],"CI:":[165,177,202,227,242],"1.301\u20132.033;":[166],"P":[167,179,204],"<":[168,180],"0.001)":[169],"1.439":[171],"disease-free":[173],"(DFS;":[175],"1.170\u20131.770;":[178],"0.001).":[181],"The":[182],"pCR":[183,256],"rate":[184],"26.34%":[186],"group":[190,196],"versus":[191],"36.18%":[192],"(adjusted":[197],"OR":[198],"0.668;":[200],"0.474\u20130.930;":[203],"0.018).":[206],"NHANES,":[208],"odds":[215],"self-reported":[218],"history":[219],"any":[221],"(OR":[223,238],"1.41;":[225],"1.19\u20131.67),":[228],"whereas":[229],"estimate":[233],"statistically":[236],"significant":[237],"1.43;":[240],"0.97\u20132.05).":[243],"Conclusion":[244],"Moderate/severe":[245],"worse":[252],"lower":[255],"this":[258],"cohort.":[261],"Reverse":[262],"causation":[263],"unaccounted-for":[265],"delivery":[267],"limit":[268],"interpretation.":[269],"These":[270],"findings":[271],"do":[272],"establish":[274],"causal":[276],"effect":[277],"or":[278],"prognostic":[280],"utility":[281],"PHQ-9":[283],"beyond":[284],"established":[285],"factors.":[286],"Prospective":[287],"studies":[288],"repeated":[290],"assessments":[292],"detailed":[294],"records":[296],"needed.":[298]},"counts_by_year":[],"updated_date":"2026-11-12T12:28:57.059296","created_date":"2026-11-12T00:00:00"}
