Quality of life after breast carcinoma surgery: a comparison of three surgical procedures.
BACKGROUND
Because breast-conserving surgery (BCS), mastectomy alone, and mastectomy with reconstruction are equally effective for the treatment of early stage breast carcinoma, women's choice among them often focuses on quality-of-life (QOL) issues. Information regarding QOL after these surgical treatments could help women with this decision.


METHODS
Participants in this prospective study were women, age 30-85 years, with newly diagnosed breast carcinoma who underwent BCS (n = 103), mastectomy alone (n = 55), or mastectomy with reconstruction (n = 40). Quality of life was assessed after diagnosis (baseline) and at 1, 3, 6, 12, 18, and 24 months after baseline by using the Mischel Uncertainty in Illness Scale, Profile of Mood States, and Functional Assessment of Cancer Therapy for Breast Cancer.


RESULTS
In multivariate regression analyses controlling for the QOL score obtained at baseline, age, and type of nonsurgical treatment, women who underwent mastectomy with reconstruction had greater mood disturbance (P = 0.002) and poorer well-being (P = 0.002) after baseline than women who had mastectomy alone; these differences remained 18 months after surgery. Although similar analyses also showed that women who underwent BCS had more mood disturbance than women who had mastectomy alone, this difference was significant only at 12 months after baseline. The BCS and mastectomy-only group did not differ significantly regarding well-being.


CONCLUSIONS
Aspects of QOL other than body image are not better in women who undergo BCS or mastectomy with reconstruction than in women who have mastectomy alone. In fact, mastectomy with reconstruction is associated with greater mood disturbance and poorer well-being.
Oncology Research, Park Nicollet Institute, Minneapolis, Minnesota 55416-2699, USA.
M J
MJ
Nissen
K K
KK
Swenson
L J
LJ
Ritz
J B
JB
Farrell
M L
ML
Sladek
R M
RM
Lally
D000328:Adult; D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000523:psychology* / Q000601:surgery*; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000523:psychology; D008408:Mastectomy / Q000523:psychology / Q000534:rehabilitation; D015412:Mastectomy, Segmental / Q000523:psychology; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012044:Regression Analysis; D011795:Surveys and Questionnaires