Psychosexual and body image aspects of quality of life in Turkish breast cancer patients: a comparison of breast conserving treatment and mastectomy.
OBJECTIVE
Assessing psychosexual and body image aspects of quality of life in Turkish breast cancer patients treated by either mastectomy or breast conserving treatment (BCT).


METHODS
The study group consisted of 112 patients who had undergone all treatment at a single institution under the care of a multidisciplinary breast team. Following surgery, all patients underwent adjuvant radiotherapy with or without chemotherapy and hormone therapy. At the time of this study all patients were disease free with at least 2 years' follow-up. Twenty percent of the patients were premenopausal and 80% postmenopausal. The patients completed a questionnaire consisting of 42 questions related to their sexual relations and body image.


RESULTS
Forty-one percent of sexually active patients had experienced a deterioration of sexual functioning after treatment. This was mainly due to loss of libido (80%), loss of interest in partner (54%), and sexual dissatisfaction (59%). Problems tended to develop early in the course of treatment. Decreased sexual desire was significantly more frequent in patients undergoing mastectomy versus BCT (80% vs 61%; P = 0.043) and in premenopausal versus postmenopausal patients (P = 0.024). Although 80% of patients were satisfied with their appearance as a whole, only 54% liked their naked bodies. There was no significant difference in body image scores between patients undergoing mastectomy or BCT apart from a general feeling of physical unattractiveness in mastectomy patients (3.4 vs 2.8; P = 0.03).


CONCLUSIONS
Significant, similar psychosexual and body image problems occur in patients treated for breast cancer with either mastectomy or BCT. Problems arise early in the course of the disease and therefore detection and treatment of these problems should be addressed during the patients' initial assessment and at the start of treatment. These findings are similar to those reported on similar groups of treated women in American and European populations.
Alicikus
Zumre Arican
ZA
Department of Radiation Oncology, Dokuz Eylul University Medical School, Izmir, Turkey. zlarican@yahoo.com
Gorken
Ilknur Bilkay
IB
Sen
Rachel Cooper
RC
Kentli
Suleyman
S
Kinay
Munir
M
Alanyali
Hilmi
H
Harmancioglu
Omer
O
D000328:Adult; D000368:Aged; D001828:Body Image; D001943:Breast Neoplasms / Q000523:psychology* / Q000601:surgery*; D005260:Female; D006801:Humans; D015411:Mastectomy, Modified Radical / Q000523:psychology*; D015412:Mastectomy, Segmental / Q000523:psychology*; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D017698:Postmenopause; D017697:Premenopause; D011788:Quality of Life; D012725:Sexual Behavior; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology* / Q000523:psychology; D012747:Sexual Partners; D011795:Surveys and Questionnaires; D014421:Turkey; D016387:Women's Health