Sexual dysfunctions are highly prevalent among young women with breast cancer. This appears to improve after treatment has been completed, but women are far from recovered. The initiative to discuss sexuality should lie with the health professional. Including sexuality within treatment guidelines will prevent women with breast cancer from being deprived of care.

Summary.  The aim of this pilot study was to investigate the effects of the transition from paediatric to adult health care services in haemophilia patients and their parents. We compared pretransition children (n = 9) and their parents (n = 18) to posttransition patients (n = 8) and their parents (n = 21). Pre‐ and posttransition patients did not differ in self‐rated health‐related quality of life (QoL) or worries about the transition. Fathers of posttransition patients rated their son’s QoL as poorer than those of pretransition patients (P = 0.034) and indicated higher levels of illness‐related distress than fathers of pretransition patients (P = 0.034). The findings indicate that the transition affects parents more than patients. Moreover, we found gender differences in parental worries about the transition. The findings indicate that programmes designed to facilitate the transition in haemophilic patients should also address the patients’ parents.

Study objectives-To assess the psychological impact of mammographic screening on women with non-malignant outcomes after attending the Netherlands' National Breast Cancer Screening Programme. Design-During one year all women with false positive test results (95) in a screening area were invited for the study. Each false positive was matched with two women with normal mammograms with respect to age and municipality. A random reference group of 400 was drawn from the female population in an area not yet included in the screening programme. Experiences with screening and psychological status of subjects were assessed 8-10 weeks after screening (T1) and again after six months (T2), by interviews as well as questionnaires. References completed two questionnaires with a six months' interval. Participants-74 (78%) women with false positive outcomes and 113 (59%) women with negative outcomes participated at TI, of these 65 (88%) and 105 (93%) at T2, respectively; 238 references returned questionnaires at Ti (59%), of these 143 (60%) at T2.Main results-At 8-10 weeks after the screening, the women who received false positive test results scored higher on most of the variables indicating psychological disfunctioning than women with normal mammograms, but did not notably differ on the same variables from the nonscreened reference group. Women with normal mammograms had the lowest scores on all the variables in the study at both assessments. The same situation was observed six months later. Although 61% of the women who received false positive mammograms reported that they had experienced the "false alarm" as a stressful event, this experience had apparently no adverse effects on their psychological functioning, as assessed 8-10 weeks after screening. Conclusions-Overall, breast screening is not likely to generate adverse psychological effects in "healthy" women, even if the outcome is false positive. Differences in psychological functioning between false positives and negatives are more likely ascribable to feelings of relief in the negative group than to raised anxiety and distress in the false positive group. (7 Epidemiol Community Health 1997;51:705-7 10) Not only will the number of women who may benefit from regular mammography increase by the diffusion of population based screening, but also the number of women who may be affected by psychological side effects. Side effects can arise from different stages of the screening process, from the invitation for mammography confronting women with the possibility of having breast cancer to the diagnosis of a breast cancer that was not suspected. The comparatively few studies on the subject suggest that the psychological impact of breast screening followed by a negative outcome is negligible or non-existent in "psychologically healthy" women, but that a false positive outcome can cause emotional disturbances up till six months or more after being informed that the abnormal mammogram did not imply breast cancer."-3 Women with false positive outcomes and subsequent clin...

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