Breast conservation versus mastectomy. Is there a difference in psychological adjustment or quality of life in the year after surgery?

Authors

  • Patricia A. Ganz MD,

    Corresponding author
    1. Department of Medicine, University of California Los Angeles-San Fernando Valley Program, Veterans Affairs Medical Center, Sepulveda, California
    2. UCLA Cancer Rehabilitation Project, Division of Cancer Control, Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, California
    • Department of Medicine (111B), VAMC, 16111 Plummer Street, Sepulveda, CA 91343
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  • C. Coscarelli Anne Schag PhD,

    1. UCLA Cancer Rehabilitation Project, Division of Cancer Control, Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, California
    2. Department of Psychiatry and Biobehavioral Sciences and Department of Medicine, University of California Los Angeles, Los Angeles
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  • J. Jack Lee PhD,

    1. Department of Biostatistics, School of Public Health, University of California Los Angeles, Los Angeles
    2. The BASE Unit, Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles
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  • Margaret L. Polinsky PhD,

    1. UCLA Cancer Rehabilitation Project, Division of Cancer Control, Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, California
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  • Shu-Jane Tan MS

    1. The BASE Unit, Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles
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Abstract

Women with a breast cancer diagnosis often are given a choice between breast conservation or mastectomy as the primary treatment for their cancer. Despite the high frequency of this cancer, there is little systemic information about the effect of surgical treatment on the quality of life or psychological adjustment of the patient. In this study, the authors prospectively evaluated quality of life, performance status, and psychological adjustment in 109 women who had primary breast cancer treatment. During the year of follow-up, no statistically significant differences in quality of life, mood disturbance, performance status, or global adjustment were found between the two surgical groups, and both groups of patients improved significantly during the year of observation (P = 0.0001). As was predicted, patients receiving mastectomy reported more difficulties with clothing and body image; however, these results apparently did not affect the assessment of mood or quality of life. The authors conclude that patients receiving breast conservation therapy do not experience significantly better quality of life or mood than patients having mastectomy; however, patients having breast conservation surgery have fewer problems with clothing and body image. Women receiving breast conservation therapy may require more intensive psychosocial intervention in the postoperative period because of the added burden of primary radiation therapy.

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