van Heeringen C, Van Moffaert M, de Cuypere G
Department of Psychiatry, University Hospital, Ghent, Belgium.
Psychother Psychosom. 1989;51(4):175-9. doi: 10.1159/000288153.
The impact of the loss of the breast in women undergoing surgical treatment for breast cancer is subordinated to the confrontation with the diagnosis of a malignancy in causing depression. The equal distribution of depression in mastectomy and in lumpectomy patients supports the hypothesis that it is the confrontation with the potentially lethal outcome of the diagnosis which is decisive in causing depression. The grief reaction following mastectomy has two components: a depressive reaction to the loss of the breast and an anticipatory grief for anticipation of the potentially lethal outcome. Psychosocial therapeutic support in breast malignancy must give priority to coping with the diagnosis of cancer over the loss of the breast.
对于接受乳腺癌手术治疗的女性而言，乳房缺失所产生的影响，相较于面对恶性肿瘤诊断所引发的抑郁情绪，处于次要地位。乳房切除术患者与保乳手术患者中抑郁情绪的均等分布，支持了这样一种假说，即正是面对诊断所带来的潜在致命后果，才是导致抑郁情绪的决定性因素。乳房切除术后的悲伤反应包含两个部分：对乳房缺失的抑郁反应，以及对潜在致命后果的预期性悲伤。对于乳腺恶性肿瘤患者的心理社会治疗支持，必须将应对癌症诊断置于比乳房缺失更为优先的位置。
