Physical and psychosocial outcomes of midlife and older women following surgery and adjuvant therapy for breast cancer.

PURPOSE/OBJECTIVES: To investigate the patterns of functioning and psychosocial adjustment of midlife and older women following surgery for breast cancer. Differences between those who received follow-up adjuvant therapy and those who did not also were compared.

DESIGN

2 x 3 mixed design with one between-groups factor (type of treatment) and one within-subjects factor (time).

SETTING

Four midwestern hospitals.

SAMPLE

46 patients with breast cancer who are age 55 or older.

METHODS

Baseline data about presurgical functional status and other variables were obtained during the first week after surgery. Follow-up data were obtained at six weeks, three months, and six months postsurgery. Data were collected via telephone interviews and mailed questionnaires.

MAIN RESEARCH VARIABLES

Functional status, patient symptomatology, quality of life (QOL), demands of illness, and type of treatment (surgery only versus surgery plus adjuvant therapy).

FINDINGS

No differences existed between the two treatment groups at baseline, with the exception of lower functional status reported by the surgery-only group. In the surgery-only group, functional status improved significantly from six weeks to three months postsurgery. The most frequently reported symptoms of both groups included fatigue and pain.

CONCLUSIONS

These results suggest that both groups did equally well, regardless of whether they received adjuvant therapy (radiation or chemotherapy). Neither QOL nor demands of illness differed between the two groups, nor did these scores change significantly over time following surgery.

IMPLICATIONS FOR NURSING PRACTICE

These findings suggest that women undergoing surgery for breast cancer, whether they receive adjuvant therapy or not, may have functional and psychosocial needs that could be effectively addressed by nursing interventions pre- and postsurgery.