The effect of radical and conserving surgery on the quality of life of early breast cancer patients.

In a randomized trial at the Leiden University Hospital, comparing (modified) radical mastectomy with tumorectomy followed by radiotherapy, all patients have been studied with respect to the quality of their lives 11 months and 18 months after surgery. The body image of women was more severely impaired after mastectomy than it was after breast conserving treatment (P less than 0.01). This was true for both younger and older women. Fear of recurrence of cancer was not related to the type of treatment. Thus, from a psychological point of view, breast conserving treatment is to be preferred in women of all ages. The overall quality of life improved and the suffering from psychological and physical complaints decreased with time in both groups of patients. This change may, therefore, have to be attributed to getting over the experience of having had cancer, and not to the treatment schedule.