Mastectomy versus conservative surgery and radiation therapy. Psychosocial consequences
CancerPublished 15 February 1994
Wendy S. Schain, Teresa D'Angelo, Marsha Dunn, Allen S. Lichter, Lori J. Pierce
Citations122
SJR quartileQ1
SJR score2.95
SNIP1.90
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TL;DR
The question remains as to whether conservative surgery plus radiation therapy confers a measure of psychological comfort superior to that of mastectomy for women diagnosed with early‐stage breast cancer.
Abstract
From our findings, it appears that breast conservation therapy protects women's perception of their body but does not, over time, contribute to a more positive sexual adjustment.
Keywords
MedicineBiochemistry, Genetics and Molecular Biology
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1,599 Citations1989Bernard Fisher, Carol Redmond +13 more
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BMJPsychiatric problems in the first year after mastectomy.
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BMJEffects of breast conservation on psychological morbidity associated with diagnosis and treatment of early breast cancer.
330 Citations1986Lesley Fallowfield, Michael Baum +1 more
Findings question the view that mutilating treatment is predominantly responsible for the measurable psychiatric morbidity reported previously and suggest counselling services should be provided for all women treated for breast cancer, not just those who undergo mastectomy.
Handbook of Psychooncology: Psychological Care of the Patient with Cancer
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American Journal of PsychiatryPresidential Address: Our Patients' Future in a Changing World: The Imperative for Psychiatric Involvement in Public Policy
215 Citations1985John A. Talbott
Patients who had reconstructive breast surgery at the time of mastectomy or within 1 year ( early) had significantly less recalled distress about their mastectomy than those who had it more than 1 year later (delayed).
Journal of Chronic DiseasesDepression and body image following mastectomy and lumpectomy
180 Citations1987Jean-Claude M. Lasry, Richard G. Margolese +6 more
The psychological and social adjustment following total and partial mastectomy in a group of patients randomly assigned to one or the other operation (National Surgical Adjuvant Breast Protocol--B-06) is investigated.
CancerPsychosocial outcome in a randomized surgical trial for treatment of primary breast cancer
171 Citations1988Margaret Kemeny, David K. Wellisch +1 more
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The British Journal of PsychiatryClinical Pharmacology and Pharmacokinetics of Fluoxetine: A Review
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American Journal of PsychiatryPsychological outcome of lumpectomy versus mastectomy in the treatment of breast cancer
144 Citations1985Steinberg, Juliano Ma +1 more
Lumpectomy patients reported less of a loss of feelings of attractiveness and femininity, were less self-conscious about their appearance, received more emotional support from friends, and were more open about their surgery and sexual feelings after surgery.
Breast Cancer Research and TreatmentPsychosocial and physical outcomes of primary breast cancer therapy: Mastectomy vs excisional biopsy and irradiation
141 Citations1983Wendy S. Schain, Brenda K. Edwards +5 more
Patients treated for primary breast cancer as part of a prospective randomized clinical trial were questioned retrospectively as to their psychosocial adaptation to treatment, and there were no marked psychossocial differences detected between these groups.
International Journal of Radiation Oncology*Biology*PhysicsPsychological effects of breast conserving therapy in comparison with radical mastectomy
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Body image in the BCT group was significantly more positive than in the RM group and patients treated with BCT had even less fear of recurrence of the cancer and would, if necessary, choose the same treatment again.
CancerA comparison of the psychological effects of breast-saving procedure with the modified radical mastectomy
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It was concluded that marital satisfaction is stable regardless of the surgical procedure undergone to treat the breast cancer, and there was no difference in the psychological adjustment of the two groups.
Journal of Clinical EpidemiologyPsychological distress after initial treatment for breast cancer: A comparison of partial and total mastectomy
120 Citations1989Elizabeth Maunsell, Jacques Brisson +1 more
It is suggested that partial mastectomy does not protect against psychological distress after breast cancer, and the importance of adequate preparation and support for all breast cancer patients, regardless of type of initial surgery, is highlighted.
Journal of Clinical OncologyBreast conservation versus mastectomy: distress sequelae as a function of choice.
114 Citations1989Sandra M. Levy, Ronald B. Herberman +3 more
When "choice" played a major role, the conservation patients were psychologically worse off--at least at 3-month's follow-up, according to a repeated measures multivariate analysis of covariance analysis.
Psychosomatic MedicineA Psychosomatic Survey of Cancer of the Breast
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Journal of the Royal Society of MedicineBreast Cancer — Patient Choice of Treatment: Preliminary Communication
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Very little adverse psychosocial reaction has been found in patients who have undergone treatment for breast cancer, and it would appear that this is largely because most patients could opt for treatment which resulted in minimal disfigurement.
PubMedPsychosocial adjustment after treatment for early breast cancer.
85 Citations1990Lesley Fallowfield
It is most important that the understanding of the premorbid personality characteristics and sociodemographic factors that may predispose certain women to failure of adjustment following a diagnosis of breast cancer are improved.
Journal of Consulting and Clinical PsychologySexual functioning among breast cancer, gynecologic cancer, and healthy women.
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BMJMastectomy or conservation: the patient's choice.
62 Citations1988Michael Baum, Lesley Fallowfield +1 more
Evidence shows that overdiagnosis has not occurred in either the Health Insurance Plan study or the Swedish studies, and Dr Skrabanek has a valid point that incomplete accounts of the Swedish study have been published internationally.
The British Journal of PsychiatryBody Image Problems in Cancer Patients
61 Citations1988Penelope Hopwood, G. P. Maguire
CancerPsychosocial adjustment after mastectomy and breast-conserving treatment
61 Citations1989Lars Holmberg, Marianne Omne-Pontén +3 more
Journal of Clinical OncologyFactors influencing options in primary breast cancer treatment.
61 Citations1987William H. Wolberg, Martin A. Tanner +3 more
Among candidates for breast conservation, the importance of retaining the breast appeared to be determined to a significant degree by measurable psychological factors.
PsychosomaticsPsychological Factors in the Choice of Treatment for Breast Cancer
57 Citations1989Gerald J. Margolis, Robert L. Goodman +2 more
Those lumpectomy-radiation therapy patients who chose the treatment against medical advice were found to be more concerned than the others about treatment effects on sexuality and many more anticipatory concerns about body image, disfigurement, femininity, and the ability to handle emotionally a mastectomy were expressed.
BMJMastectomy or conservation: the patient's choice.
56 Citations1988Richard Guy Wilson, A. Hart +1 more
Patients with breast cancer are capable of choosing treatment and should play a part in deciding which treatment to have, and they do not automatically choose to retain the breast.
British journal of surgeryChoice of surgery for early breast cancer: Pre- and postoperative levels of clinical anxiety and depression in patients and their husbands
50 Citations1987Jenny Morris, G T Royle
Patients offered a choice of surgery had similar pre‐ and postoperative levels of anxiety and depression to patients with benign breast disease and patients undergoing surgery for non‐cancerous conditions.
Stress MedicinePsychological outcome of treatment for early breast cancer: A review
33 Citations1989Angela Hall, Lesley Fallowfield
This paper critically reviews 10 studies which compare the psychological outcome of treatment for early breast cancer by either mastectomy or breast-conserving procedures and concludes that less mutilating techniques protect women from psychological and sexual dysfunction.
British journal of surgeryReduced psychological morbidity after breast conservation
31 Citations1990J. M C McArdle, A.V.M. Hughson +1 more
It is suggested that breast conservation reduces psychological morbidity, and there was a significant excess of severe depression in the mastectomy group.
Seminars in Surgical OncologyBreast conservation versus mastectomy: Psychological considerations
22 Citations1989Peter Maguire
Attention still needs to be paid to the early recognition and treatment of psychological problems in patients with breast cancer, and guidelines are provided.
Journal of Sex Education and TherapyThe Impact of Mastectomy on Sexual Self-Image, Attitudes, and Behavior
9 Citations1978Vicki Abt, Martin C. McGurrin +1 more
Results indicate that women desire more pre- and post-operative sexual counseling than usually provided; typically experience change in sexual self-image, attitudes and behavior; and change least when they receive candid supportive counseling on sexual implications of mastectomy.
