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A study of the differences in the psychosocial effects of mastectomy versus segmentectomy was done on a group of women who were in a prospective randomized protocol for treatment of primary breast cancer. Through questionnaires designed for this study and standardized psychologic tests, women with segmentectomies responded as significantly less anxious, less sad, and more in control of their life events than women with mastectomies. The women with segmentectomies had a statistically more positive sexual and body image than those with mastectomies. The trauma of viewing the surgery was much greater in patients with mastectomies. The concern about cancer recurrence was less in the segmentectomy group. The differences in psychosexual adaptation to mastectomy or segmentectomy and the fears of cancer recurrence were significantly better in the segmentectomy group. The adequacies of cancer therapy was the same for both groups in the national study. This study restresses the importance of the segmentectomy option for women with breast cancer in leading to a better quality of life.