Original Article
Does cosmetic outcome from treatment of primary breast cancer influence psychosocial morbidity?

https://doi.org/10.1053/ejso.1999.0708Get rights and content

Abstract

Aims: To investigate any influence of cosmetic outcome on psychosocial morbidity in patients who have undergone breast-conserving surgery for primary breast cancer. Methods: Cosmetic outcome was assessed both objectively and subjectively in 254 patients, aged 20–69 years, who underwent breast-conserving surgery for operable primary breast cancer, ≤3 cm in diameter; most women also received post-operative intact breast irradiation. Patients completed questionnaires assessing satisfaction with the outcome and assessing other psychosocial morbidity using the Hospital Anxiety Depression scale, the Body Image questionnaire and the Rosenberg Self-esteem scale. Results: Patient satisfaction was high (90.5% of the patients were very or moderately satisfied). There was an excellent correlation between cosmesis and levels of anxiety (r=−0.81, P<0.001) and depression (r=−0.7, P<0.001) and between cosmesis and body image (r=−0.4, P<0.001), sexuality (χ2=22, P=0.001) and self-esteem (r=−0.64,P <0.001). Conclusions: This study has shown that the cosmetic result achieved has a marked bearing on the subsequent development of psychological outcome.

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    Citation Excerpt :

    Additional toxicity may be imparted by this additional coverage. Cosmetic changes can cause psychological distress years after treatment.14,15 Patients are also at an increased risk of cardiovascular mortality and secondary malignancies, which are outcomes that are dependent on the dose received by the heart and lungs, respectively.16

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This paper was presented at the 56th scientific meeting of the British Association of Surgical Oncology (BASO), 25–26 June 1998.

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Correspondence to: Mr Sharif K. Al-Ghazal, Clinical Research Fellow, Professorial Unit of Surgery, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK. Fax. +44 115 962 7765.

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