Anxiety and Depression in Breast Cancer Patients Before and After Chemotherapy: A Pre–Post Study Without a Control Group

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Background: Emotional disturbances such as anxiety and depression are common in breast cancer patients and may intensify during systemic therapy. This study aimed to assess changes in the severity of anxiety and depression among women undergoing neoadjuvant chemotherapy and to identify factors influencing emotional outcomes. Methods: A total of 211 women with stage I–III breast cancer treated at the Podkarpackie Oncology Center in Brzozów, Poland, were included. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS) one week before and three weeks after chemotherapy. Statistical analyses were performed using the Wilcoxon signed-rank test and descriptive statistics (STATISTICA v.13). Results: After chemotherapy, anxiety and depression levels increased significantly. Nearly half of the patients experienced clinically relevant anxiety, and over one-third showed symptoms of depression. The emotional burden appeared particularly high among women reporting financial difficulties. In contrast, no clear associations were found with marital status, place of residence, or cancer stage. Conclusions: Chemotherapy in breast cancer patients is associated with a significant increase in anxiety and depression severity. Routine psychological assessment and psycho-oncological support should be implemented as integral components of oncological care, with particular attention to patients in disadvantaged socioeconomic conditions.

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