SELF-PERCEPTIONS OF WOMEN AFTER EARLY BREAST-CANCER SURGERY

Aims. To discover satisfaction with treatment decision and the late in fluences of surgery for early breast cancer on the lives and self-perc eptions of women. Methods. A two-part mail survey was returned by 90 w omen aged 2.8-7.6 years after breast-conserving treatment (BCT) and by 56 women aged 3.0-8.0 years after modified radical mastectomy (MRM). Results. Approximately one-third of all patients felt the information and time before the treatment decision was inadequate. Most women in b oth treatment groups had participated in treatment decision-making. Wh en the surgeon alone had made the choice it did not affect satisfactio n with the treatment result. Few patients regretted the treatment moda lity chosen. The majority of patients felt no discomfort in their trea ted breast, but a quarter of all the women suffered from rib pain. Fif teen of 52 sexually active women reported of reduced breast pleasure s ensation in their resected breast. The women in both treatment groups were asked to score a summary satisfaction index (SSI) on a scale of 0 -10 for seven different areas of life: cosmesis, function, work, home, recreation/sports, social life and sexuality. SSI was used as a measu re of quality of life. There was a difference in all these categories between BCT and MRM groups, the former giving significantly higher val ues. Post-menopausal women tended to be more satisfied than younger wo men and women over 70 years showed no difference in satisfaction betwe en the two treatment modalities. Treatment of early breast cancer caus ed little morbidity in the long run. After MRM slightly more local sym ptoms were reported. Conclusions. Most women treated with breast-conse rving surgery esteemed their life normal or close to normal, giving us a reason to favour BCT when suitable. For women over 70 years old mas tectomy remains a viable alternative.