Effects of mastectomy versus lumpectomy on emotional adjustment to breast cancer: a prospective study of the first year postsurgery.
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.
Pozo
C
C
Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY.
Carver
C S
CS
Noriega
V
V
Harris
S D
SD
Robinson
D S
DS
Ketcham
A S
AS
Legaspi
A
A
Moffat
F L
FL
Clark
K C
KC
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