title: Second operation is not related to psychological outcome in breast cancer patients.
abstract: To examine the effect of multiple surgical treatments on psychological outcomes in women with early stage breast cancer (BC) in a prospective follow-up study. Questionnaires for depressive symptoms (CES-D), fatigue (FAS), anxiety (STAI-State), physical health (WHOQOL-100), psychological health (WHOQOL-100) and overall quality of life and general health (WHOQOL-100) were completed before diagnosis (Time-1) and 1 (Time-2), 3 (Time-3), 6 (Time-4) and 12 (Time-5) months after the last surgical treatment. From the 217 participating women with early stage BC, 78 (35.9%) needed an additional surgical treatment. Using general linear model (repeated measures), psychosocial outcomes over time were investigated for the breast conserving therapy and mastectomy group, accounting for type of surgery, disease stage and hormonal therapy. Psychological outcomes did not significantly change over time, with the exception of anxiety [Wilks' Lambda = 0.72, F (4,86) = 8.55, p < 0.0001, partial eta squared = 0.29]. On average, women with 1 and women with 2 surgical treatments did not differ on any outcome measure. No interaction effects were found, indicating that changes in outcomes over time were the same for both groups. Women who had a repeat surgical treatment did not score differently on psychological outcome measures compared with women who were treated "efficiently."
authors.affiliation: Department of Medical Psychology, CoRPS-Center of Research on Psychology in Somatic Diseases, Tilburg University, LE Tilburg 5000, The Netherlands.
authors.forename: Brenda L
authors.initials: BL
authors.lastname: Den Oudsten
authors.forename: Guus L
authors.initials: GL
authors.lastname: Van Heck
authors.forename: Alida F W
authors.initials: AF
authors.lastname: Van der Steeg
authors.forename: Jan A
authors.initials: JA
authors.lastname: Roukema
authors.forename: Jolanda
authors.initials: J
authors.lastname: De Vries
mesh_terms: D000368:Aged; D001007:Anxiety / Q000523:psychology; D001943:Breast Neoplasms / Q000523:psychology* / Q000601:surgery*; D003863:Depression / Q000523:psychology; D005221:Fatigue / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008408:Mastectomy / Q000379:methods / Q000523:psychology* / Q000706:statistics & numerical data; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011788:Quality of Life; D012086:Reoperation; D011795:Surveys and Questionnaires