title: Effects of mastectomy versus lumpectomy on emotional adjustment to breast cancer: a prospective study of the first year postsurgery.
abstract: OBJECTIVE
  Procedure (mastectomy v lumpectomy) and choice of procedure were examined as predictors of adjustment to breast cancer in a prospective study of the experiences of the first year after surgery.
  
  
  METHODS
  Breast cancer patients were interviewed the day before surgery, 10 days after surgery, and at the 3-month, 6-month, and 12-month follow-ups. Patients included 24 women who received mastectomy on strong recommendation, 24 who chose mastectomy for other reasons, and 15 who chose lumpectomy. Subjective well-being was assessed in terms of mood disturbance, perceived quality of life, life satisfaction, marital satisfaction, perceptions of social support, and self-rated adjustment.
  
  
  RESULTS
  Surgical groups differed in well-being in only one respect: lumpectomy patients reported a higher-quality sex life at 6 and 12 months postsurgery than mastectomy patients. Choice of surgical procedure predicted higher levels of life satisfaction at 3 months.
  
  
  CONCLUSIONS
  The lack of difference between surgical groups in areas other than sexual adjustment replicates previous findings, but extends them by (1) using a fully prospective design, (2) providing data on the period surrounding the surgery (as well as later periods), and (3) examining a broader range of indices of well-being than usual.
authors.affiliation: Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY.
authors.forename: C
authors.initials: C
authors.lastname: Pozo
authors.forename: C S
authors.initials: CS
authors.lastname: Carver
authors.forename: V
authors.initials: V
authors.lastname: Noriega
authors.forename: S D
authors.initials: SD
authors.lastname: Harris
authors.forename: D S
authors.initials: DS
authors.lastname: Robinson
authors.forename: A S
authors.initials: AS
authors.lastname: Ketcham
authors.forename: A
authors.initials: A
authors.lastname: Legaspi
authors.forename: F L
authors.initials: FL
authors.lastname: Moffat
authors.forename: K C
authors.initials: KC
authors.lastname: Clark
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000523:psychology* / Q000601:surgery; D004644:Emotions; D004651:Employment; D005260:Female; D006801:Humans; D015411:Mastectomy, Modified Radical / Q000523:psychology*; D015412:Mastectomy, Segmental / Q000523:psychology*; D008875:Middle Aged; D010358:Patient Participation / Q000523:psychology*; D011446:Prospective Studies; D011788:Quality of Life; D012725:Sexual Behavior; D012944:Social Support