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    Breast conservation versus mastectomy: psychological considerations.

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    Authors
    Maguire, Peter
    Affiliation
    Cancer Research Campaign Psychological Medicine Group, Christie Hospital, Manchester, England.
    Issue Date
    1989
    
    Metadata
    Show full item record
    Abstract
    From the available evidence it is clear that mastectomy is associated with a substantial psychological and psychiatric morbidity. To date there is no convincing evidence that counseling can prevent this morbidity, but monitoring of women's psychological adjustment can lead to early detection and effective treatment of their problem. The use of immediate or delayed implantation or reconstruction appears to reduce the psychiatric morbidity in those women who are particularly concerned about their appearance at the time of surgery. Psychiatric morbidity is further increased when adjuvant chemotherapy is used and when treatment results in persistent arm pain and swelling. A shorter course of adjuvant chemotherapy and reduction of surgery within the axilla could reduce psychiatric morbidity. The role of radiotherapy is still unclear, but in some studies a link has been found between the amount of radiotherapy given, adverse effects, and psychiatric morbidity. In women undergoing breast conservation the reduction in body image problems is offset by greater anxiety about recurrence and depression caused by radiotherapy. Exploring and allowing choice when a patient has a strong preference for breast conservation or mastectomy appears to reduce morbidity. But attention still needs to be paid to the early recognition and treatment of psychological problems in patients with breast cancer, and guidelines are provided.
    Citation
    Breast conservation versus mastectomy: psychological considerations. 1989, 5 (2):137-44 Semin Surg Oncol
    Journal
    Seminars in Surgical Oncology
    URI
    http://hdl.handle.net/10541/110825
    DOI
    10.1002/ssu.2980050210
    PubMed ID
    2543051
    Type
    Article
    Language
    en
    ISSN
    8756-0437
    ae974a485f413a2113503eed53cd6c53
    10.1002/ssu.2980050210
    Scopus Count
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    All Christie Publications

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