Wolberg W H, Romsaas E P, Tanner M A, Malec J F
Department of Surgery, University of Wisconsin--Madison.
Cancer. 1989 Apr 15;63(8):1645-55. doi: 10.1002/1097-0142(19890415)63:8<1645::aid-cncr2820630835>3.0.co;2-8.
Disturbances associated with a breast cancer diagnosis were defined when psychological assessments from 63 patients with a known breast cancer diagnosis were compared to those from 56 patients with an as yet undiagnosed malignancy. Subsequent assessments from the 56 patients with an undiagnosed breast cancer showed disturbances after they saw a physician compared with the assessments from 72 similar patients ultimately diagnosed as benign. Apprehension apparently arose from clues given before a biopsy was done even though the cancer was not yet diagnosed. Compared with the benign breast disease group, the disturbances in patients suspected or diagnosed with breast cancer were found chiefly in assessments of mood and adjustment, and less in assessments of more durable characteristics of personality, psychopathology, and sexual behavior. Psychological problems associated with breast cancer decreased over time, but residuals persisted for at least 16 months postoperatively. Few differences were found between 41 patients who elected breast-conserving surgery and 78 who were treated with mastectomy. Problems were not eliminated by operations which saved the breast.
当将63名已知患有乳腺癌的患者的心理评估结果与56名尚未确诊恶性肿瘤的患者的心理评估结果进行比较时，确定了与乳腺癌诊断相关的干扰因素。56名未确诊乳腺癌的患者在看过医生后的后续评估显示，与72名最终被诊断为良性的类似患者的评估相比，他们出现了干扰因素。即使癌症尚未确诊，恐惧显然也源于活检前给出的线索。与良性乳腺疾病组相比，疑似或确诊患有乳腺癌的患者的干扰因素主要出现在情绪和适应评估方面，而在人格、精神病理学和性行为等更持久特征的评估方面则较少。与乳腺癌相关的心理问题会随着时间的推移而减少，但术后至少16个月仍会有残留。在选择保乳手术的41名患者和接受乳房切除术的78名患者之间几乎没有发现差异。保留乳房的手术并没有消除这些问题。
