Jeon Sook Young, Kim Kyoung-Eun, Kim Eun-Kyu, Han Hyunhee, Lee Han-Byoel, Han Wonshik, Noh Dong-Young, Moon Hyeong-Gon
Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.
Pusan National University Hospital, Busan Cancer Center, Pusan, Republic of Korea.
J Oncol. 2021 Mar 12;2021:6636986. doi: 10.1155/2021/6636986. eCollection 2021.
We examined the incidence of emotional distress in women with newly diagnosed breast cancer to determine whether the degree of emotional distress affected their choice of breast-conserving surgery (BCS) or mastectomy and evaluated how the patient's preferred role in decision-making influenced her choice of surgical method.
This prospective study included 85 patients newly diagnosed with in situ or invasive breast cancer eligible for BCS. Their degree of depression/anxiety and attitude toward the decision-making process were measured using the Hospital Anxiety and Depression Scale (HADS) and Control Preference Scale (CPS), respectively. After receiving information on both surgical methods, the patients indicated their preferred surgical method and completed the CPS at their initial and second visits before surgery.
After the diagnosis of breast cancer, 75.3% of patients showed abnormal or borderline HADS scores for depression and 41.2% for anxiety. Patients with borderline or abnormal degrees of depression were more likely to have coexisting abnormal degrees of anxiety ( < 0.001). However, the presence of depression or anxiety was not associated with patients' surgical choices (=0.394 and 0.530, respectively). Patients who preferred a more active role in the decision-making process were more likely to choose mastectomy over BCS, while those who were passive or collaborative chose BCS more frequently (=0.001).
Although many patients with newly diagnosed breast cancer experience depression and anxiety before surgery, these do not affect the choice of surgical method; however, their attitudes toward the decision-making process do.
我们调查了新诊断为乳腺癌的女性的情绪困扰发生率，以确定情绪困扰程度是否会影响她们对保乳手术（BCS）或乳房切除术的选择，并评估患者在决策中偏好的角色如何影响其手术方法的选择。
这项前瞻性研究纳入了85例新诊断为原位或浸润性乳腺癌且符合保乳手术条件的患者。分别使用医院焦虑抑郁量表（HADS）和控制偏好量表（CPS）测量她们的抑郁/焦虑程度以及对决策过程的态度。在了解两种手术方法的信息后，患者表明其偏好的手术方法，并在术前首次和第二次就诊时完成CPS。
乳腺癌诊断后，75.3%的患者抑郁的HADS评分异常或处于临界值，41.2%的患者焦虑的HADS评分异常或处于临界值。抑郁程度处于临界或异常的患者更有可能同时存在异常程度的焦虑（<0.001）。然而，抑郁或焦虑的存在与患者的手术选择无关（分别为=0.394和0.530）。在决策过程中偏好更积极角色的患者比保乳手术更倾向于选择乳房切除术，而那些被动或合作的患者更频繁地选择保乳手术（=0.001）。
尽管许多新诊断为乳腺癌的患者在手术前会经历抑郁和焦虑，但这些并不影响手术方法的选择；然而，她们对决策过程的态度会影响手术方法的选择。
