Skip to main content
Annals of Surgery logoLink to Annals of Surgery
. 1988 Feb;207(2):189–194. doi: 10.1097/00000658-198802000-00013

The patient's appraisal of the cosmetic result of segmental mastectomy in benign and malignant breast disease.

L Holmberg 1, E Zarén 1, H O Adami 1, R Bergström 1, T Burns 1
PMCID: PMC1493378  PMID: 3341817

Abstract

Women's appraisal of the cosmetic result and their psychosocial adjustment after a standardized segmental mastectomy for benign or malignant breast disease was analyzed on the basis of a mailed questionnaire, which was satisfactorily answered by 263 (92%) of 285 women operated on consecutively. The overall result was favorable: 96.5% of the patients found the new appearance of their breast very good (30.7%), good (44.0%), or acceptable (21.8%). Women with a benign diagnosis ran a two-fold higher risk of being discontented with the new appearance of the breast than those with breast cancer. Complications of radiation therapy, preoperative concern that the breasts are important for the appearance, and anxiousness about the cosmetic result were associated with a significantly elevated risk of being less satisfied with the outcome. The main finding that it is possible to perform a locally radical operation that is highly acceptable to the woman is relevant to the surgical management of potentially malignant mammographic lesions and also to the scientific strategies for future evaluation of breast-conserving treatment modes in malignant disease.

Full text

PDF
189

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bartelink H., van Dam F., van Dongen J. Psychological effects of breast conserving therapy in comparison with radical mastectomy. Int J Radiat Oncol Biol Phys. 1985 Feb;11(2):381–385. doi: 10.1016/0360-3016(85)90161-0. [DOI] [PubMed] [Google Scholar]
  2. Beadle G. F., Come S., Henderson I. C., Silver B., Hellman S., Harris J. R. The effect of adjuvant chemotherapy on the cosmetic results after primary radiation treatment for early stage breast cancer. Int J Radiat Oncol Biol Phys. 1984 Nov;10(11):2131–2137. doi: 10.1016/0360-3016(84)90213-x. [DOI] [PubMed] [Google Scholar]
  3. Beadle G. F., Silver B., Botnick L., Hellman S., Harris J. R. Cosmetic results following primary radiation therapy for early breast cancer. Cancer. 1984 Dec 15;54(12):2911–2918. doi: 10.1002/1097-0142(19841215)54:12<2911::aid-cncr2820541216>3.0.co;2-v. [DOI] [PubMed] [Google Scholar]
  4. Clarke D., Martinez A., Cox R. S. Analysis of cosmetic results and complications in patients with stage I and II breast cancer treated by biopsy and irradiation. Int J Radiat Oncol Biol Phys. 1983 Dec;9(12):1807–1813. doi: 10.1016/0360-3016(83)90348-6. [DOI] [PubMed] [Google Scholar]
  5. Clarke D., Martinez A., Cox R. S., Goffinet D. R. Breast edema following staging axillary node dissection in patients with breast carcinoma treated by radical radiotherapy. Cancer. 1982 Jun 1;49(11):2295–2299. doi: 10.1002/1097-0142(19820601)49:11<2295::aid-cncr2820491116>3.0.co;2-g. [DOI] [PubMed] [Google Scholar]
  6. Collette H. J., Day N. E., Rombach J. J., de Waard F. Evaluation of screening for breast cancer in a non-randomised study (the DOM project) by means of a case-control study. Lancet. 1984 Jun 2;1(8388):1224–1226. doi: 10.1016/s0140-6736(84)91704-5. [DOI] [PubMed] [Google Scholar]
  7. Dean C., Chetty U., Forrest A. P. Effects of immediate breast reconstruction on psychosocial morbidity after mastectomy. Lancet. 1983 Feb 26;1(8322):459–462. doi: 10.1016/s0140-6736(83)91452-6. [DOI] [PubMed] [Google Scholar]
  8. Durand J. C., Poljicak M., Lefranc J. P., Pilleron J. P. Wide excision of the tumor, axillary dissection, and postoperative radiotherapy as treatment of small breast cancers. Cancer. 1984 Jun 1;53(11):2439–2443. doi: 10.1002/1097-0142(19840601)53:11<2439::aid-cncr2820531113>3.0.co;2-8. [DOI] [PubMed] [Google Scholar]
  9. Fisher B., Bauer M., Margolese R., Poisson R., Pilch Y., Redmond C., Fisher E., Wolmark N., Deutsch M., Montague E. Five-year 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 Mar 14;312(11):665–673. doi: 10.1056/NEJM198503143121101. [DOI] [PubMed] [Google Scholar]
  10. Fisher E. R., Sass R., Fisher B., Gregorio R., Brown R., Wickerham L. Pathologic findings from the National Surgical Adjuvant Breast Project (protocol 6). II. Relation of local breast recurrence to multicentricity. Cancer. 1986 May 1;57(9):1717–1724. doi: 10.1002/1097-0142(19860501)57:9<1717::aid-cncr2820570902>3.0.co;2-h. [DOI] [PubMed] [Google Scholar]
  11. Harris J. R., Hellman S., Kinne D. W. Limited surgery and radiotherapy for early breast cancer. N Engl J Med. 1985 Nov 21;313(21):1365–1368. doi: 10.1056/nejm198511213132128. [DOI] [PubMed] [Google Scholar]
  12. Hayward J. L. The Guy's trial of treatments of "early" breast cancer. World J Surg. 1977 May;1(3):314–316. doi: 10.1007/BF01556846. [DOI] [PubMed] [Google Scholar]
  13. Hughes J. Emotional reactions to the diagnosis and treatment of early breast cancer. J Psychosom Res. 1982;26(2):277–283. doi: 10.1016/0022-3999(82)90047-2. [DOI] [PubMed] [Google Scholar]
  14. Patterson M. P., Pezner R. D., Hill L. R., Vora N. L., Desai K. R., Lipsett J. A. Patient self-evaluation of cosmetic outcome of breast-preserving cancer treatment. Int J Radiat Oncol Biol Phys. 1985 Oct;11(10):1849–1852. doi: 10.1016/0360-3016(85)90044-6. [DOI] [PubMed] [Google Scholar]
  15. Romsdahl M. M., Montague E. D., Ames F. C., Richards P. C., Schell S. R. Conservation surgery and irradiation as treatment for early breast cancer. Arch Surg. 1983 May;118(5):521–528. doi: 10.1001/archsurg.1983.01390050005001. [DOI] [PubMed] [Google Scholar]
  16. Sarrazin D., Lê M., Rouëssé J., Contesso G., Petit J. Y., Lacour J., Viguier J., Hill C. Conservative treatment versus mastectomy in breast cancer tumors with macroscopic diameter of 20 millimeters or less. The experience of the Institut Gustave-Roussy. Cancer. 1984 Mar 1;53(5):1209–1213. doi: 10.1002/1097-0142(19840301)53:5<1209::aid-cncr2820530531>3.0.co;2-y. [DOI] [PubMed] [Google Scholar]
  17. Shapiro S., Venet W., Strax P., Venet L., Roeser R. Ten- to fourteen-year effect of screening on breast cancer mortality. J Natl Cancer Inst. 1982 Aug;69(2):349–355. [PubMed] [Google Scholar]
  18. Tabàr L., Gad A. Screening for breast cancer: the Swedish trial. Radiology. 1981 Jan;138(1):219–222. doi: 10.1148/radiology.138.1.7005939. [DOI] [PubMed] [Google Scholar]
  19. Tabár L., Fagerberg C. J., Gad A., Baldetorp L., Holmberg L. H., Gröntoft O., Ljungquist U., Lundström B., Månson J. C., Eklund G. Reduction in mortality from breast cancer after mass screening with mammography. Randomised trial from the Breast Cancer Screening Working Group of the Swedish National Board of Health and Welfare. Lancet. 1985 Apr 13;1(8433):829–832. doi: 10.1016/s0140-6736(85)92204-4. [DOI] [PubMed] [Google Scholar]
  20. Verbeek A. L., Hendriks J. H., Holland R., Mravunac M., Sturmans F., Day N. E. Reduction of breast cancer mortality through mass screening with modern mammography. First results of the Nijmegen project, 1975-1981. Lancet. 1984 Jun 2;1(8388):1222–1224. doi: 10.1016/s0140-6736(84)91703-3. [DOI] [PubMed] [Google Scholar]
  21. Veronesi U., Saccozzi R., Del Vecchio M., Banfi A., Clemente C., De Lena M., Gallus G., Greco M., Luini A., Marubini E. Comparing radical mastectomy with quadrantectomy, axillary dissection, and radiotherapy in patients with small cancers of the breast. N Engl J Med. 1981 Jul 2;305(1):6–11. doi: 10.1056/NEJM198107023050102. [DOI] [PubMed] [Google Scholar]
  22. Walker S. H., Duncan D. B. Estimation of the probability of an event as a function of several independent variables. Biometrika. 1967 Jun;54(1):167–179. [PubMed] [Google Scholar]
  23. Weisman A. D. Early diagnosis of vulnerability in cancer patients. Am J Med Sci. 1976 Mar-Apr;271(2):187–196. doi: 10.1097/00000441-197603000-00007. [DOI] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES