A new study published in the Journal of Clinical Oncology shows that women with a history of depression are less likely to obtain the recommended care for breast cancer.

During the study, researchers looked at more than 45,000 Danish women who were diagnosed between 1998 and 2011 with early stage breast cancer. Of those women, 13 percent had taken antidepressants and 2 percent had visited a hospital for depression previously.

The data showed that the patients who took antidepressants were less likely to receive the recommended breast cancer treatments. These women also had overall shorter survival lengths, compared to the women in the study who never took antidepressants.

The researchers (comprised of Dr. Nis Suppli of the Danish Cancer Society Research Center, and his colleagues) also found that five years after the breast cancer diagnosis, 13 percent of the patients who had taken antidepressants had died of the cancer. This is compared to only 11 percent of the patients who had never taken antidepressants. The study’s authors suggest that these numbers are because women who took antidepressants were less likely to receive the breast cancer treatments that were recommended to them.

Although the reasons for this result is unknown, it raises awareness for doctors to follow up with patients who have a history of depression and pay careful attention to their treatment. In many cases, women who struggle with mental health issues need assistance with the medical care system.