Maunsell E, Brisson J, Deschenes L
Départment de Médecine sociale et préventive, Faculté de Médecine, Université Laval, Québec, Canada.
J Clin Epidemiol. 1989;42(8):765-71. doi: 10.1016/0895-4356(89)90074-7.
This study of the relation between type of mastectomy and psychological distress was based on all newly diagnosed breast cancer patients with localized or regional disease who were surgically treated in seven Quebec City hospitals in 1984. Among 235 eligible patients, 227 (96%) participated in a home interview 3 months after diagnosis and 205 of these women gave a second interview approximately 15 months later. The Psychiatric Symptom Index (PSI) was used to measure the severity of symptoms of psychological distress. At 3 months, 38.8% of partial mastectomy patients had high PSI scores compared to 25.8% of women treated by total mastectomy (OR = 1.8, p = 0.044). Fifteen months later, percentages with high scores were identical, 35.1%, in the two treatment groups. Age appeared to modify the surgery-distress relation. These results suggest that partial mastectomy does not protect against psychological distress after breast cancer. Moreover, they highlight the importance of adequate preparation and support for all breast cancer patients, regardless of type of initial surgery.
这项关于乳房切除术类型与心理困扰之间关系的研究，基于1984年在魁北克市七家医院接受手术治疗的所有新诊断出患有局部或区域性疾病的乳腺癌患者。在235名符合条件的患者中，227名（96%）在诊断后3个月接受了家访，其中205名女性在大约15个月后接受了第二次访谈。采用精神症状指数（PSI）来衡量心理困扰症状的严重程度。在3个月时，部分乳房切除术患者中38.8%的人PSI得分较高，而接受全乳房切除术的女性中这一比例为25.8%（比值比=1.8，p=0.044）。15个月后，两个治疗组中高分患者的百分比相同，均为35.1%。年龄似乎会改变手术与困扰之间的关系。这些结果表明，部分乳房切除术并不能预防乳腺癌后的心理困扰。此外，它们凸显了对所有乳腺癌患者进行充分准备和支持的重要性，无论初始手术类型如何。
