title: Psychosocial effect of mastectomy versus conservative surgery in patients with early breast cancer.
abstract: OBJECTIVE
  To compare the quality-of-life (QoL) and psychosocial changes in a group of patients with early breast cancer who underwent conservative surgery (BCS) or modified radical mastectomy(MRM).
  
  
  METHODS
  Self-administered questionnaire assessing body image perception, social habits, sexual attraction and self-consciousness with relatives/friends, was randomly assigned to 125 patients (61 BCS, 64 MRM; aged 53 +/- 8 and 50 + 9 years, respectively, p = NS).
  
  
  RESULTS
  MRM patients reported a significantly higher frequency of changes in body image perception and other related social behaviour such as avoiding going to the beach or using low-cut clothes, and reticence with friends. Conversely, no differences were found regarding sexuality, denial of the disease by the husband/partner, or concealing the disease from family members. Also, no significant differences were found between patients above and below the age of 50 years, for all variables studied after adjustment for surgical procedure.
  
  
  CONCLUSIONS
  Modified radical mastectomy has a negative effect on body image perception and in social behaviour patterns of patients and with a concomitant decrease in QoL. The sexuality of the patient is not significantly affected.
authors.affiliation: Serviço de Radioterapia, Hospital de Santa Maria, Centro de Nutrição e Metabolismo, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Portugal. imonteiro.grillo@hsm.min-saude.pt
authors.forename: Isabel
authors.initials: I
authors.lastname: Monteiro-Grillo
authors.forename: Pedro
authors.initials: P
authors.lastname: Marques-Vidal
authors.forename: Marília
authors.initials: M
authors.lastname: Jorge
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001828:Body Image; D001943:Breast Neoplasms / Q000188:drug therapy / Q000523:psychology* / Q000532:radiotherapy / Q000601:surgery; D003020:Clothing; D003131:Combined Modality Therapy; D003717:Denial, Psychological; D005195:Family Relations; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D015411:Mastectomy, Modified Radical / Q000523:psychology*; D015412:Mastectomy, Segmental / Q000523:psychology*; D008875:Middle Aged; D009376:Neoplasms, Hormone-Dependent / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D011174:Portugal; D011584:Psychology; D018714:Radiotherapy, Adjuvant; D012649:Self Concept; D019529:Sexuality; D012919:Social Behavior; D012944:Social Support; D018454:Spouses / Q000523:psychology; D014342:Truth Disclosure
chemical_list: D000970:Antineoplastic Agents; D018931:Antineoplastic Agents, Hormonal