Subtle differences in quality of life after breast cancer surgery

Background: Lumpectomy with axillary dissection (LAD) has taken its place a longside mastectomy (M) as the treatment of choice for stage I and II breas t cancer. Its appeal is based on lessening disfigurement and thus improving quality of life. Methods: We used the SF-36 Health Survey modified with ten questions releva nt to breast cancer surgery to evaluate whether quality of life with LAD wa s better than with mastectomy in women with stage I and II disease. The add itional questions addressed satisfaction with intimate relationships and se xuality, and explored impact on the way women dress, use bathing suits, hug people, are comfortable with nudity, and rate their sexual drive and sexua l responsiveness. Results: LAD was not associated with statistically significant better quali ty-of-life scores on any SF-36 questions, except vitality (P = .02). No dif ferences were noted in the areas of intimacy and sexual satisfaction. LAD p atients reported significant differences in matters of dress, use of bathin g suits, hugging, comfort with nudity, and sexual drive compared to patient s undergoing mastectomy. Conclusions: The SF-36 health survey detected few differences in quality of life measures between patients with LAD and those with mastectomy. However , LAD impacts favorably on the way women dress, on comfort with nudity, and on sexual drive.