Breast conservationversus mastectomy. Is there a difference in psychological adjustment or quality of life in the year after surgery?

Ganz, Patricia A.; Schag, Cyndie Coscarelli; Lee, John; Polinsky, Margaret L.; Tan, Shu‐Jane ‐J

doi:10.1002/1097-0142(19920401)69:7<1729::aid-cncr2820690714>3.0.co;2-d

Cited by 300 publications

(174 citation statements)

References 34 publications

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“…In addition to global QOL, assessment of emotional functioning shows low levels at baseline too, with no significant changes during follow-up in both groups. An explanation for low levels at baseline is that patients being informed about the breast cancer diagnosis before surgery induced psychological distress (Fallowfield et al, 1986;Ganz et al, 1992;Coscarelli Schag et al, 1993). In this study the Karnofsky performance status score was, for most patients, over 90 at baseline and showed no differences in patients' physical condition in both groups during follow-up.…”

Section: Discussionmentioning

confidence: 55%

Comparison of quality of life and arm complaints after axillary lymph node dissection vs sentinel lymph node biopsy in breast cancer patients

Peintinger¹,

et al. 2003

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The sentinel lymph node biopsy (SLNB) represents a minimal invasive surgical method for axillary staging in patients with primary breast cancer. In a prospective study, evaluation of quality of life (QOL) and arm morbidity was performed before surgery on a total of 56 breast cancer patients. The EORTC QLQ-C30 and EORTC QLQ-BR23 questionnaires were used for QOL assessment. Assessment of pain was additionally observed using the McGill Pain Questionnaire. Arm mobility was observed by goniometric measurement of arm movement. Data were collected before surgery (t1), 1 week after discharge (t2) and 9 -12 months after surgery (t3). The type of axillary surgery does not seem to affect global QOL at a short-time follow-up, but patients recover sooner after SLNB. Body image and sexual functioning remain stable in both types of axillary surgery. Arm/shoulder pain was reported in 36% of patients after SLNB in comparison to 68% receiving axillary lymph node dissection (ALND), and 'numbness' was reported only in 4% of patients in the SLNB group vs 19.3% after ALND. Abduction, flexion and horizontal adduction of the affected arm show significant impairment after ALND. Breast cancer patients should be counselled about the benefits of SLNB over ALND concerning QOL and postsurgery side effects in a short-term follow-up. Axillary lymph node dissection (ALND) in breast cancer patients still represents the routine surgical method for axillary staging. Although the axillary node status is the most important prognostic factor for recurrence and survival (Fisher et al, 1984;Carter et al, 1989) and information obtained by axillary dissection is useful for planning adjuvant treatment, it is associated with substantial morbidity (Kissin et al, 1986;Ivens et al, 1992;Keramopoulos et al, 1993;Hack et al, 1999;Kakuda et al, 1999) and psychological distress (Maunsell et al, 1993;Tobin et al, 1993;Shimozuma et al, 1999). Hack et al, showed arm/shoulder pain, weakness or numbness in 72% and impaired range of motion in 73% of breast cancer patients after ALND, whereas high levels of quality of life (QOL) were reported. Moderate to severe pain was reported between 20, 23 and 32% (Van Dam et al, 1993;Kuehn et al, 2000;Ververs et al, 2001) and was not significantly related to time since surgery. Other reports suggest that arm problems after ALND are associated with a negative effect on the overall QOL of breast cancer patients (Maunsell et al, 1993;Kuehn et al, 2000). As a result of the need to reduce axillary morbidity, many investigations have been performed on sentinel lymph node biopsy (SLNB), an alternative procedure. Using vital dye and/or radiocolloid, the sentinel node/s as the first lymph node to receive lymphatic drainage from the primary tumour can be identified by a minimal invasive surgical technique. Recently, published data showed no sensory morbidity after SLNB (Giuliano et al, 2000) at a median follow-up of 39 months. Schrenk et al (2000) reported less postoperative arm pain, numbness and arm motion restriction after SLNB at a foll...

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Section: Discussionmentioning

confidence: 55%

Comparison of quality of life and arm complaints after axillary lymph node dissection vs sentinel lymph node biopsy in breast cancer patients

Peintinger¹,

et al. 2003

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“…In contrast, Vinokur et al (1990) identified age in women with breast cancer (Lauria, 1991). Improved emotional responses and fewer rehabilitation problems were found in older rather than in younger cancer patients (Vinokur et al, 1990;Ganz et al, 1992;Moor et al, 1994).…”

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confidence: 87%

“…Other investigators reported no significant relationship between age and functional status (Vinokur et al, 1990;Ganz et al, 1992;Given et al, 1994). Current trends in health care aim to reduce hospital beds in acute care units.…”

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confidence: 99%

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Physical and psychosocial outcomes in cancer patients: a comparison of different age groups

Greimel¹,

Padilla²,

Grant³

1997

Br J Cancer

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Summary In a cross-sectional study, we investigated the relationship between age, physical health, social and economic resources, functional status, activities of daily living (ADL) and disease-related variables of 227 patients with cancer. Using multidimensional outcome measures we examined age differences in three age groups (< 45, 46-65, >65 years) and identified predictors of performing ADL. The results indicated that older patients have outcomes similar to those of younger patients. There were no significant differences in quality of life, performance status and physical health among the three age groups. The only areas where age-related differences were found were comorbidity and cancer-related impairments. Patients aged 45-65 years and patients 65 years and older reported a higher level of co-morbidity and more cancer-related impairments than those aged 45 and younger. Although older patients had higher co-morbidity, they showed similar Karnofsky Performance Status (KPS) scores to those of their younger counterparts. The regression analysis revealed social resources, selfreported health, performance status and complexity of care as significant predictors of patients' ADL, but not age, co-morbidity or severity of treatment. The findings support the conclusion that differences in performing ADL between younger and older patients with cancer are minimal and tend to be due to co-morbidity. Thus, treatment should be decided by a patient's physical health rather than by age.

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“…the surgery in which the whole breast is removed) (e.g. Ganz et al, 1992a;Janz et al, 2005;Moyer, 1997;Poulsen et al, 1997). The only difference between surgeries appears to be on body image and sexual functioning, as patients treated with mastectomy report more concerns with appearance and more sexual difficulties than those treated with BCS (e.g.…”

Section: Introductionmentioning

confidence: 99%

The Portuguese version of the Body Image Scale (BIS) – psychometric properties in a sample of breast cancer patients

Moreira

Silva

Marques

et al. 2010

European Journal of Oncology Nursing

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Keywords:Body image scale Instrument Body image Cancer Portuguese version EORTC Breast cancer a b s t r a c t Purpose: The aim of this study was to analyse the psychometric properties of the Portuguese version of the body image scale (BIS; Hopwood, P., Fletcher, I., Lee, A., Al Ghazal, S., 2001. A body image scale for use with cancer patients. European Journal of Cancer, 37,[189][190][191][192][193][194][195][196][197]. This is a brief and psychometric robust measure of body image for use with cancer patients, independently of age, cancer type, treatment or stage of the disease and it was developed in collaboration with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Study Group. Method: The sample is comprised of 173 Portuguese postoperative breast cancer patients that completed a battery of measures that included the BIS and other scales of body image and quality of life, in order to explore its construct validity. Results: The Portuguese version of BIS confirmed the original unidimensional structure and demonstrated adequate internal consistency, both in the global sample (a ¼ .93) as in surgical subgroups (mastectomy ¼ .92 and breast-conserving surgery ¼ .93). Evidence for the construct validity was provided through moderate to largely sized correlations between the BIS and other related measures. In further support of its discriminant validity, significant differences in BIS scores were found between women who underwent mastectomy and those who underwent breast-conserving surgery, with the former presenting higher scores. Age and time since diagnosis were not associated with BIS scores. Conclusions: The Portuguese BIS proved to be a reliable and valid measure of body image concerns in a sample of breast cancer patients, allowing a brief and comprehensive assessment, both on clinical and research settings.

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Breast conservationversus mastectomy. Is there a difference in psychological adjustment or quality of life in the year after surgery?

Cited by 300 publications

References 34 publications

Comparison of quality of life and arm complaints after axillary lymph node dissection vs sentinel lymph node biopsy in breast cancer patients

Comparison of quality of life and arm complaints after axillary lymph node dissection vs sentinel lymph node biopsy in breast cancer patients

Physical and psychosocial outcomes in cancer patients: a comparison of different age groups

The Portuguese version of the Body Image Scale (BIS) – psychometric properties in a sample of breast cancer patients

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