Unukovych Dmytro, Johansson Hemming, Johansson Elizabeth, Arver Brita, Liljegren Annelie, Brandberg Yvonne
Department of Oncology-Pathology, Karolinska Institutet, SE-17176 Stockholm, Sweden.
Department of Oncology-Pathology, Karolinska Institutet, SE-17176 Stockholm, Sweden.
Breast. 2014 Aug;23(4):357-63. doi: 10.1016/j.breast.2014.01.010. Epub 2014 Feb 10.
The rate of prophylactic mastectomies (PM) is increasing. Patients generally report high levels of health related quality of life and satisfaction after the procedure, whereas body image perception and sexuality may be negatively affected. The aim of the study was to evaluate the interest in physical therapy as a means of improving body image and sexuality in women after PM.
Patients undergoing PM at Karolinska University Hospital between 2006 and 2010 were eligible. The following patient-reported outcome measures were used at study baseline and 2 years postoperatively: the body image scale (BIS), the sexual activity questionnaire (SAQ), the short-form health survey (SF-36), the hospital anxiety and depression scale (HAD), and a study specific "pain/motion/sensation scale".
Out of 125 patients invited to participate in this prospective randomized study, 43 (34%) consented and were randomized into the intervention (n = 24, 56%) or control (n = 19, 44%) groups. There were no statistically significant between-group differences found with respect to BIS, SAQ, SF-36, HAD, and "pain/motion/sensation". Two years postoperatively, more than half of the patients in both groups reported problems like feeling less attractive, less sexually attractive, their body feeling less whole, and being dissatisfied with their body. A majority marked a decreased sensation in breast area.
The interest in a physiotherapy intervention was limited among women who had undergone PM. The intervention did not show any substantial effects. A large proportion of patients reported specific body image related and pain/motion/sensation problems postoperatively.
预防性乳房切除术（PM）的比例正在上升。患者通常报告术后与健康相关的生活质量和满意度较高，而身体形象认知和性功能可能会受到负面影响。本研究的目的是评估物理治疗作为改善PM术后女性身体形象和性功能的一种手段的效果。
2006年至2010年间在卡罗林斯卡大学医院接受PM的患者符合条件。在研究基线和术后2年使用以下患者报告的结局指标：身体形象量表（BIS）、性活动问卷（SAQ）、简短健康调查问卷（SF-36）、医院焦虑抑郁量表（HAD）以及一项特定研究的“疼痛/运动/感觉量表”。
在125名受邀参加这项前瞻性随机研究的患者中，43名（34%）同意并被随机分为干预组（n = 24，56%）或对照组（n = 19，44%）。在BIS、SAQ、SF-36、HAD和“疼痛/运动/感觉”方面，两组之间未发现统计学上的显著差异。术后2年，两组中超过一半的患者报告存在诸如感觉缺乏吸引力、性吸引力下降、身体感觉不完整以及对自己的身体不满意等问题。大多数患者表示乳房区域感觉减退。
接受PM的女性对物理治疗干预的兴趣有限。该干预未显示出任何实质性效果。很大一部分患者术后报告了与身体形象相关的特定问题以及疼痛/运动/感觉问题。
