Omne-Pontén M, Holmberg L, Sjödén P O
Dalarnas Research Institute, Falun, Sweden.
J Clin Oncol. 1994 Sep;12(9):1778-82. doi: 10.1200/JCO.1994.12.9.1778.
To evaluate, in a long-term follow-up study of consecutive patients (N = 99), the impact of surgery--breast-conserving treatment (BCT) versus mastectomy (MT)--on psychosocial adjustment among women with breast cancer, pTNM stage I/II.
Semistructured interviews were conducted at a median of 6 years (range, 5.8 to 8.1) after primary surgery. Sixty-six women were available for the long-term follow-up study. Twenty-six women had been treated with BCT and 40 with MT.
No statistically significant differences were found between the two groups concerning psychosocial adjustment, as measured by the Social adjustment Scale (SAS). In general, the levels of maladjustment were lower than at 13 months postoperatively, but 10% still showed maladjustment. Sixty percent of the women were unwilling to show themselves naked, and 22% felt that they had become less attractive because of the surgical treatment. In an explorative part of the interview, 68% of the women complained about how they had been informed of the diagnosis. A tendency toward a significant difference was found in the relation between previous maladjustment and a negative experience at the time of diagnosis (P = .07).
Few data are available on long-term follow-up results with regard to psychosocial adjustment among women after breast cancer surgery. This study provides the important information that there are no differences in patient psychosocial adjustment that can be ascribed to the type of surgery at 6-year follow-up evaluation.
在一项针对连续患者(N = 99)的长期随访研究中,评估手术——保乳治疗(BCT)与乳房切除术(MT)——对Ⅰ/Ⅱ期pTNM乳腺癌女性心理社会调适的影响。
在初次手术后中位时间6年(范围5.8至8.1年)进行半结构式访谈。66名女性可纳入长期随访研究。26名女性接受了保乳治疗,40名接受了乳房切除术。
通过社会调适量表(SAS)测量,两组在心理社会调适方面未发现统计学上的显著差异。总体而言,调适不良水平低于术后13个月时,但仍有10%表现出调适不良。60%的女性不愿裸露身体,22%觉得手术治疗使她们变得不那么有吸引力了。在访谈的探索性部分,68%的女性抱怨了她们得知诊断的方式。在既往调适不良与诊断时的负面经历之间的关系中发现了显著差异的趋势(P = 0.07)。
关于乳腺癌手术后女性心理社会调适的长期随访结果,现有数据较少。本研究提供了重要信息,即在6年随访评估中,患者的心理社会调适不存在可归因于手术类型的差异。