Patient satisfaction with cosmetic outcome and the psychological impact of breast cancer surgery were evaluated. A total of 207 patients with primary breast cancer, treated with either breast-conserving surgery (n = 83), modified radical mastectomy without reconstruction (n = 108), or mastectomy with delayed breast reconstruction (n = 16) rated their cosmetic outcome and satisfaction following surgery, and the impact of surgery on their self-esteem and sexual life, by questionnaire. Patients undergoing breast-conserving surgery were most satisfied with their surgery and body image, followed by those treated with mastectomy with delayed reconstruction. Although diagnosis of breast cancer had a negative impact on the psychology of all patients, those undergoing breast-conserving surgery or mastectomy with delayed reconstruction were more satisfied and reported a lower impact on their self-esteem and sexual life versus those who only had mastectomy. Diagnosis of breast cancer has a negative psychological impact on the patient, but the type of surgery has a significant role in post-operative self-esteem and sexual life.
Nowadays, many important changes to residents' education are being introduced, including the regulation of working hours, the waiting time to start specialization, the training programs in new technologies, the heterogeneity of trainers and educational centers, and the existence of many different subspecializations. In Greece we have not yet established all the arrangements needed to meet the European Community's legislation concerning working hours apart from the extremely long waiting time to begin surgical training. There is an enormous heterogeneity among hospitals that provide surgical specialties, but there is no educational program that all residents have to follow to complete their training. Only in major university or general hospitals are the residents enrolled in a specific educational program and complete an adequate number of surgical procedures. With respect to training in new technologies, there is a lack of experienced surgical departments around Greece that provide this type of education to all residents. Of course, efforts have been made to meet the international educational criteria and there are many major general hospitals that can provide an adequate and up-to-date surgical education, although much still needs to be done to meet the international standards.
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