Ganz P A, Schag A C, Lee J J, Polinsky M L, Tan S J
Department of Medicine, University of California Los Angeles-San Fernando Valley Program.
Cancer. 1992 Apr 1;69(7):1729-38. doi: 10.1002/1097-0142(19920401)69:7<1729::aid-cncr2820690714>3.0.co;2-d.
Women with a breast cancer diagnosis often are given a choice between breast conservation or mastectomy as the primary treatment for their cancer. Despite the high frequency of this cancer, there is little systemic information about the effect of surgical treatment on the quality of life or psychological adjustment of the patient. In this study, the authors prospectively evaluated quality of life, performance status, and psychological adjustment in 109 women who had primary breast cancer treatment. During the year of follow-up, no statistically significant differences in quality of life, mood disturbance, performance status, or global adjustment were found between the two surgical groups, and both groups of patients improved significantly during the year of observation (P = 0.0001). As was predicted, patients receiving mastectomy reported more difficulties with clothing and body image; however, these results apparently did not affect the assessment of mood or quality of life. The authors conclude that patients receiving breast conservation therapy do not experience significantly better quality of life or mood than patients having mastectomy; however, patients having breast conservation surgery have fewer problems with clothing and body image. Women receiving breast conservation therapy may require more intensive psychosocial intervention in the postoperative period because of the added burden of primary radiation therapy.
被诊断患有乳腺癌的女性通常会在保乳手术或乳房切除术之间做出选择，作为其癌症的主要治疗方法。尽管这种癌症发病率很高，但关于手术治疗对患者生活质量或心理调适的影响，几乎没有系统的信息。在本研究中，作者前瞻性地评估了109例接受原发性乳腺癌治疗的女性的生活质量、身体状况及心理调适情况。在随访的一年中，两个手术组在生活质量、情绪障碍、身体状况或整体调适方面均未发现统计学上的显著差异，并且两组患者在观察期内均有显著改善（P = 0.0001）。正如所预测的那样，接受乳房切除术的患者在着装和身体形象方面报告了更多困难；然而，这些结果显然并未影响对情绪或生活质量的评估。作者得出结论，接受保乳治疗的患者在生活质量或情绪方面并不比接受乳房切除术的患者显著更好；然而，接受保乳手术的患者在着装和身体形象方面问题较少。由于原发性放射治疗带来的额外负担，接受保乳治疗的女性在术后可能需要更密集的社会心理干预。
