CYP19A1 and major depressive disorder: In addition, psychosocial stress, anxiety, depression, sleep disturbances, sarcopenic weight gain, and low cardiorespiratory fitness are prevalent in BC patients and each of these has been implicated in the pathogenesis of autonomic dysfunction.28, 29, 30 Hormonal therapy with tamoxifen has been associated with weight gain and aromatase inhibitors with musculoskeletal discomfort.