title: Subtle differences in quality of life after breast cancer surgery.
abstract: BACKGROUND
  Lumpectomy with axillary dissection (LAD) has taken its place alongside mastectomy (M) as the treatment of choice for stage I and II breast cancer. Its appeal is based on lessening disfigurement and thus improving quality of life.
  
  
  METHODS
  We used the SF-36 Health Survey modified with ten questions relevant to breast cancer surgery to evaluate whether quality of life with LAD was better than with mastectomy in women with stage I and II disease. The additional questions addressed satisfaction with intimate relationships and sexuality, and explored impact on the way women dress, use bathing suits, hug people, are comfortable with nudity, and rate their sexual drive and sexual responsiveness.
  
  
  RESULTS
  LAD was not associated with statistically significant better quality-of-life scores on any SF-36 questions, except vitality (P = .02). No differences were noted in the areas of intimacy and sexual satisfaction. LAD patients reported significant differences in matters of dress, use of bathing suits, hugging, comfort with nudity, and sexual drive compared to patients undergoing mastectomy.
  
  
  CONCLUSIONS
  The SF-36 health survey detected few differences in quality of life measures between patients with LAD and those with mastectomy. However, LAD impacts favorably on the way women dress, on comfort with nudity, and on sexual drive.
authors.affiliation: Department of Surgery, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick 08903, USA.
authors.forename: I L
authors.initials: IL
authors.lastname: Wapnir
authors.forename: R P
authors.initials: RP
authors.lastname: Cody
authors.forename: R S
authors.initials: RS
authors.lastname: Greco
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008197:Lymph Node Excision; D008408:Mastectomy / Q000523:psychology*; D015412:Mastectomy, Segmental / Q000523:psychology*; D008875:Middle Aged; D011788:Quality of Life