Chang Joseph Tung-Chieh, Chen Chun-Je, Lin Yun-Chan, Chen Yuan-Chua, Lin Chien-Yu, Cheng Ann-Joy
Department of Radiation Oncology, Chang Gung Memorial Hospital-Linkou Medical Center, Taoyuan, Taiwan.
Int J Radiat Oncol Biol Phys. 2007 Sep 1;69(1):49-53. doi: 10.1016/j.ijrobp.2007.02.019. Epub 2007 May 7.
To evaluate health-related quality of life (QoL) and attitudes toward surgical procedures for breast cancer among patients in northern Taiwan.
Two hundred twenty posttreatment breast cancer patients completed a QoL survey at two different hospitals in northern Taiwan. Patients (median age, 49 years; range, 32-69 years) had either undergone mastectomy (n = 157) or breast conservation treatment (BCT) (n = 63). The Functional Assessment of Chronic Illness Therapy-Breast questionnaire was used to assess QoL. The patients were also asked about breast reconstruction or use of an artificial breast or not, as well as the decision-making process.
There was no significant difference in QoL between patients treated with BCT or mastectomy. Significantly more mastectomy patients had had breast reconstruction or wore an artificial breast (49.7% vs. 3.2%; p < 0.001). Of those who had BCT, 81% would make the same choice again, compared with only 49% of mastectomy patients (p < 0.001). Only 7.6% of patients who made the treatment decision themselves were dissatisfied with their treatment, compared with 25% for whom the decision was made by someone else (p = 0.004).
Taiwanese women with breast cancer who had undergone mastectomy did not report a worse QoL than those who received BCT, but they were more likely to be concerned about their resulting body image. Half would have chosen a less extensive procedure if they had it to do over. Women were more likely to be satisfied with the results of their treatment if they had decided themselves.
评估台湾北部乳腺癌患者的健康相关生活质量(QoL)以及对乳腺癌手术治疗的态度。
220名乳腺癌治疗后的患者在台湾北部的两家不同医院完成了一项生活质量调查。患者(中位年龄49岁;范围32 - 69岁)要么接受了乳房切除术(n = 157),要么接受了保乳治疗(BCT)(n = 63)。使用慢性病治疗功能评估-乳房问卷来评估生活质量。患者还被问及是否进行乳房重建或使用人工乳房,以及决策过程。
接受保乳治疗或乳房切除术的患者在生活质量方面没有显著差异。接受乳房切除术的患者进行乳房重建或佩戴人工乳房的比例显著更高(49.7%对3.2%;p < 0.001)。在接受保乳治疗的患者中,81%会再次做出相同的选择,而接受乳房切除术的患者中这一比例仅为49%(p < 0.001)。自己做出治疗决定的患者中只有7.6%对治疗不满意,而由他人做出决定的患者中这一比例为25%(p = 0.004)。
接受乳房切除术的台湾乳腺癌女性报告的生活质量并不比接受保乳治疗的女性差,但她们更可能担心由此产生的身体形象。如果可以重新选择,一半的人会选择创伤较小的手术。如果是自己做出决定,女性对治疗结果更可能感到满意。