Comparison of psychological aspects and patient satisfaction following breast conserving surgery, simple mastectomy and breast reconstruction

The aim of this study was to assess and compare the psychological outcome a nd satisfaction of patients whom underwent wide local excision, mastectomy alone and mastectomy with breast reconstruction. A total of 577 patients ha d different types of operations for primary breast cancer (254 (44%) had wi de local excision, 202 (35%) had simple mastectomy and 121 (21%) had breast reconstruction). Psychosocial morbidity and satisfaction were studied retr ospectively using self-evaluation questionnaires. The three different surgi cal groups were cross-matched into four different age group. Significant st atistical differences existed between the three procedures regarding satisf action and psychosocial morbidity (anxiety, depression, body image, sexuali ty and self-esteem) in favour of wide local excision followed by breast rec onstruction. Greatest morbidity was seen in the mastectomy group. Patient s atisfaction of cosmetic outcome and psychosocial aspects was greater with w ide local excision than with breast reconstruction or mastectomy. However, since wide local excision is indicated in only a group of patients, breast reconstruction should be an option available to patients requiring mastecto my. (C) 2000 Elsevier Science Ltd. All rights reserved.