Schover L R, Yetman R J, Tuason L J, Meisler E, Esselstyn C B, Hermann R E, Grundfest-Broniatowski S, Dowden R V
Center for Sexual Function, Cleveland Clinic Foundation, OH 44195-5041.
Cancer. 1995 Jan 1;75(1):54-64. doi: 10.1002/1097-0142(19950101)75:1<54::aid-cncr2820750111>3.0.co;2-i.
This retrospective study compared psychosocial adjustment, body image, and sexual function in women who had either breast conservation or reconstruction for early stage disease.
Questionnaires were completed at a mean of 4 years after surgery by 72 women who had partial mastectomy and 146 women who had immediate breast reconstruction after mastectomy.
In general, fewer than 20% of women reported poor adjustment on the domains measured. The two groups did not differ in overall psychosocial adjustment to illness, body image, or satisfaction with relationships or sexual life. There was a specific advantage of partial mastectomy over breast reconstruction in terms of maintaining pleasure and frequency of breast caressing during sexual activity. Women who had undergone chemotherapy had more sexual dysfunction, poorer body image, and more psychological distress. Hormonal therapy and radiation therapy, however, did not measurably affect quality of life. Factors predictive of greater psychosocial distress included a troubled marriage, a poor body image, sexual dissatisfaction, less education, and treatment with chemotherapy.
The choice of local treatment had little psychosexual impact, whereas chemotherapy was associated with long term impairments.
本回顾性研究比较了早期疾病行保乳手术或乳房重建的女性的心理社会调适、身体意象及性功能。
72例行部分乳房切除术的女性和146例行乳房切除术后即刻乳房重建的女性在术后平均4年时完成问卷调查。
总体而言，在所测量的领域中，不到20%的女性报告调适不良。两组在对疾病的总体心理社会调适、身体意象、对人际关系或性生活的满意度方面无差异。在性活动期间保持乳房抚摸的愉悦感和频率方面，部分乳房切除术比乳房重建有特定优势。接受过化疗的女性性功能障碍更多、身体意象更差且心理困扰更多。然而，激素治疗和放射治疗对生活质量无明显影响。预测心理社会困扰更大的因素包括婚姻问题、身体意象差、性不满、受教育程度低及化疗治疗。
局部治疗的选择对性心理影响很小，而化疗与长期损害有关。
