Clinical and Translational Oncology

, Volume 7, Issue 11, pp 499–503 | Cite as

Psychosocial effect of mastectomy versus conservative surgery in patients with early breast cancer

  • Isabel Monteiro-Grillo
  • Pedro Marques-Vidal
  • Marília Jorge
Original Articles



To compare the quality-of-life (QoL) and psycho-social changes in a group of patients with early breast cancer who underwent conservative surgery (BCS) or modified radical mastectomy (MRM).


Self-administered questionnaire assessing body image perception, social habits, sexual attraction and self-consciousness with relatives/friends, was randomly assigned to 125 patients (61 BCS, 64 MRM; aged 53±8 and 50±9 years, respectively, p=NS).


MRM patients reported a significantly higher frequency of changes in body image perception and other related social behaviour such as avoiding going to the beach or using low-cut clothes, and reticence with friends. Conversely, no differences were found regarding sexuality, denial of the disease by the husband/partner, or concealing the disease from family members. Also, no significant differences were found between patients above and below the age of 50 years, for all variables studied after adjustment for surgical procedure.


Modified radical mastectomy has a negative effect on body image perception and in social behaviour patterns of patients and with a concomitant decrease in QoL. The sexuality of the patient is not significantly affected.

Key words

quality of life bodyimage perception mastectomy conservative surgery 


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  1. 1.
    Arora NK, Gustafson DH, Hawkins RP, et al. Impact of surgery and chemotherapy on quality of life of young women with breast carcinoma-A prospective study. Cancer. 2001;92:1288–98.PubMedCrossRefGoogle Scholar
  2. 2.
    de Haes JC, van Ootram MA, Welvaart K. The effect of radical and conserving surgery on quality of life of early breast cancer patients. Eur J Surg Oncol. 1986;12:337–42.PubMedGoogle Scholar
  3. 3.
    Ganz PA, Coscarelli A, Fred C, et al. Breast cancer survivors: psychosocial concerns and quality of life. Breast Cancer Res Treat. 1996;38:183–89.CrossRefGoogle Scholar
  4. 4.
    Rosenqvist S, Sandelin K, Wickman M. Patients' psychological and cosmetic experience after immediate breast reconstruction. Eur J Surg Oncol. 1996;22:262–6.CrossRefGoogle Scholar
  5. 5.
    Schover LR, Yetman RJ, Tuason LJ, et al. Partial mastectomy and breast reconstruction. Cancer. 1995;75:54–64.PubMedCrossRefGoogle Scholar
  6. 6.
    Fallowfield LH, Baum M, Maguire P. Effects of breast conservation on psychological morbidity associated with diagnosis and treatment of early breast cancer. Br Med J. 1986;293:1331–4.CrossRefGoogle Scholar
  7. 7.
    Mock V. Body image in women treated for breast cancer. Nurs Res 1993;142:153–157.Google Scholar
  8. 8.
    Blichert-Toft, Brincker H, Anderson J, et al. A Danish randomized trial comparing breast preverving therapy with mastectomy in breast carcinoma. Acta Oncol. 1988; 27:671–7.PubMedCrossRefGoogle Scholar
  9. 9.
    Fisher B, Bauer M, Margolese R, et al. Five years results of a randomized clinical trial comparing total mastectomy and segmental mastectomy with or without radiation in the treatment of breast cancer. N Engl J Med 1985;312:665–73.PubMedCrossRefGoogle Scholar
  10. 10.
    Sarrazin D, Lè MG, Arriagada R, et al. Ten-year results of a randomized trial comparing a conservative treatment to mastectomy in early breast cancer. Radiother Oncol. 1989;14:177–84.PubMedCrossRefGoogle Scholar
  11. 11.
    van Dongen J, Bartelink H, Fentiman I, et al. Randomized clinical trial to assess the value of breast conserving therapy in stage I and II breast cancer: EORTC 10801 trial 1. Monograph National Cancer Institute. 1992;11:15–8.Google Scholar
  12. 12.
    Veronesi H, Saccozzi R, del Vecchio M, et al. Comparing modified radical mastetomy with quadrantectomy, axillary dissection and radiotherapy in patients with small cancers of the breast. N Engl J Med. 1981;305:6–11.PubMedCrossRefGoogle Scholar
  13. 13.
    Moyer A. Psychosocial outcomes of breast-converving surgery versus mastectomy: a meta-analytic review. Health Psychol. 1997;16:442.CrossRefGoogle Scholar
  14. 14.
    Beckmann J, Johansen L, Richard C, et al. Psychological reaction in younger women operated on breast cancer. Amputation versus resection of the breast with special reference to body image, sexual identity and sexual function. Dan Med Bull. 1983;30Supl 2:10–3.PubMedGoogle Scholar
  15. 15.
    Goi MK, Goin JM. Midlife reactions to mastectomy and subsequent breast reconstruction. Arch Gen Psychiatry. 1981;36:225–7.Google Scholar
  16. 16.
    Polivy J. Psychological effects of mastectomy on a women's feminine self-concept. J Nerv Ment Dis. 1977;164: 77–87.PubMedCrossRefGoogle Scholar
  17. 17.
    Wenzel LB, Fairclough D, Brady M, et al. Age-related differences in the quality of life of breast carcinoma patients after treatment. Cancer. 1999;86:1768–74.PubMedCrossRefGoogle Scholar
  18. 18.
    Dorval M, Maunsell E, Deschenes L, et al. Long-term quality of life after breast cancer: comparison of 8 years survivors with population controls. Journal of Clinical Oncology. 1998;16:487–94.PubMedGoogle Scholar
  19. 19.
    Ganz PA, Rowland JH, Desmond K, et al. Life after breast cancer: understanding women's health-related quality of life and sexual functioning. J Clin Oncol. 1998;16(2): 501–14.PubMedGoogle Scholar
  20. 20.
    Holmberg L, Omne-Ponten M, Burns T, et al. Psychosocial adjustment after mastectomy and breast-conserving treatment. Cancer. 1989;64:969–74.PubMedCrossRefGoogle Scholar
  21. 21.
    Bartelink H, van Dam F, van Dongen J. Psychological effects of breast conserving therapy in comparison with modified radical mastectomy. Int J Radiat Oncol Biol Phys. 1985;11:381–5.PubMedGoogle Scholar
  22. 22.
    Beckmann J, Blichert-Toft M, Johansen L. Psychological effects of mastectomy. Dan Med Bull. 1983;30 Supl 2:7–10.PubMedGoogle Scholar
  23. 23.
    Schain E, Edwards B, Gorell CR, et al. Psychosocial and physical outcomes of primary breast cancer therapy: mastectomy vs. excisional biopsy and irradiation. Breast Cancer Res Treat. 1983;3:377–82.PubMedCrossRefGoogle Scholar
  24. 24.
    Fitzpatrick G. Body attitude and physical health. J Clin Psychol. 1970;26:149–51.CrossRefGoogle Scholar
  25. 26.
    Yurek D, Farrar W, Anderson BL, Breast cancer surgery: comparing surgical groups and determining individual differences in postoperative sexuality and body changes stress. J Consult Clin Psychol. 2000;68:697–709.PubMedCrossRefGoogle Scholar
  26. 27.
    Maunsell E, Brisson J, Deschenes L. Psychological distress after initial treatment of breast cancer: assessment of potential risk factors. Cancer. 1992;70:120–5.PubMedCrossRefGoogle Scholar
  27. 28.
    Sanger CK, Reznikoff M. A comparison of psychological effects of breast-saving procedures with the modified radical mastectomy. Cancer. 1981;48:2341–6.PubMedCrossRefGoogle Scholar
  28. 29.
    Shag CA, Ganz PA, Polinsky ML, et al. Characteristics of women at risk for psychosocial distress in the year after breast cancer. J Clin Oncol. 1993;11:783–93.Google Scholar
  29. 30.
    Barni S, Mondi R. Sexual dysfunction in treated breast cancer patients. Ann Oncol. 1997;8:149–53.PubMedCrossRefGoogle Scholar
  30. 31.
    Maguire G, Lee EG, Bevington DJ, et al. Psychiatric problems in the first year after mastectomy. Br Med J. 1978; 963–5.Google Scholar
  31. 32.
    Hughes J. Emotional reactions to the diagnosis and treatment of early breast cancer. J Psychosom Res. 1982;26: 277–83.PubMedCrossRefGoogle Scholar
  32. 33.
    Morris T. Psychosocial aspects of breast cancer; a review. Eur J Cancer Clin Oncol. 1985;18:1725–33.Google Scholar
  33. 34.
    Leinster SJ, Ashcroft JJ, Slade PD, et al. Mastectomy versus conservative surgery: psychological effects of the partner's choice of treatment. J Psychosocial Oncol. 1989; 7:179–92.CrossRefGoogle Scholar
  34. 35.
    Source National Breast Cancer Center. Clinical practice guidelines for the management of early breast cancer. 2a ed. 2001. Canberra, Commonwealth of Australia.Google Scholar
  35. 36.
    Gadpaille W.. The cyles of sex. New York: Charles Scribner's Son; 1975. p. 416.Google Scholar

Copyright information

© FESEO 2005

Authors and Affiliations

  • Isabel Monteiro-Grillo
    • 1
    • 2
  • Pedro Marques-Vidal
    • 2
  • Marília Jorge
    • 1
  1. 1.Serviço de RadioterapiaFaculdade de Medicina de LisboaLisboaPortugal
  2. 2.Centro de Nutri¢ão e metabolismo. Instituto de Medicina MolecularFaculdade de Medicina da Universidade de LisboaLisboaPortugal

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