Journal of Clinical Oncology, Vol 12, 1778-1782, Copyright © 1994 by American Society of Clinical Oncology
Psychosocial adjustment among women with breast cancer stages I and II: six-year follow-up of consecutive patients
M Omne-Ponten, L Holmberg and PO Sjoden
Dalarnas Research Institute, Falun, Sweden.
PURPOSE: 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. PATIENTS AND METHODS: 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. RESULTS: 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). CONCLUSION: 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.

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