Psychosocial adjustment to breast cancer in women with conservative surgery vs mastectomy

Susana Fernandes, Teresa McIntyre, Ângela Leite

Abstract


The aim of this study was to examine psychosocial adjustment differences between breast cancer women who underwent a lumpectomy or mastectomy, predicting differences between the two groups. The participants were 74 Portuguese recently diagnosed breast cancer patients, recruited in the main Oncology Hospital of the North of Portugal. The study design is longitudinal with four-time points: before surgery (baseline); two weeks after surgery, during adjuvant treatments; and at the end of adjuvant treatment. The evaluated dimensions were emotional state, illness perception and illness functional limitations. We didn’t find differences for most of the variables, between the two groups. However, we find significant differences for comprehension (illness perception) and for leisure, sleep and psychosocial dimension (perceived functioning), with better adjustment for women who underwent mastectomy. These results are unexpected since conservation surgery aims to provide a more satisfying cosmetic outcome and survival rates equivalent to those of mastectomy, assuming a better psychosocial adjustment. The data suggest that the type of surgery doesn’t seem to predict the psychosocial adjustment. However, involving patients in choosing surgery type, whenever it is possible, can benefits a better understanding about the disease and the treatment, with more favourable repercussions on the emotional level and functionality.

Keywords


Breast cancer, Psychosocial adjustment, Type of surgery, Mastectomy, Conservation surgery.

References


Aaronson, N. K., Mattioli, V., Minton, O., Weis, J., Johansen, C., Dalton, S. O., . . . de Boer, A. (2014). Beyond treatment – Psychosocial and behavioural issues in cancer survivorship research and practice. European Journal of Cancer Supplements, 12, 54-64. doi: 10.1016/j.ejcsup.2014.03.005

Arndt, V., Stegmaier, C., Ziegler, H., & Brenner, H. (2008). Quality of life over 5 years in women with breast cancer after breast-conserving therapy versus mastectomy: A population-based study. Journal of Cancer Research and Clinical Oncology, 134, 1311. doi: 10.1007/s00432-008-0418-y

Arroyo, J. M. G., & López, M. L. D. (2011). Psychological problems derived from mastectomy: A qualitative study. International Journal of Surgical Oncology. http://dx.doi.org/10.1155/2011/132461

Bergner, M., Bobbitt, R. A., Carter, W. B., & Gilson, B. S. (1981). The sickness impact profile: Development and final revision of a health status measure. Medical Care, 19, 787-805.

Binkley, J. M., Harris, S. R., Levangie, P. K., Pearl, M., Guglielmino, J., Kraus, V., & Rowden, D. (2012). Patient perspectives on breast cancer treatment side effects and the prospective surveillance model for physical rehabilitation for women with breast cancer. Cancer, 118, 2217-2216. doi: 10.1002/cncr.27469

Bleiker, E. M., Hendriks, J. H., Otten, J. D., Verbeek, A. L., & van Der Ploeg, H. M. (2008). Personality factors and breast cancer risk: A 13-year follow-up. Journal of the National Cancer Institute, 100, 213-218. doi: 10.1093/jnci/djm280

Bradley, E. J., Calvert, E., Pitts, M. K., & Redman, C. W. E. (2001). Illness Identity and self-regulatory model in recovery from early stage gynaecological cancer. Journal of Health Psychology, 6, 511-521. doi: 10.1177/135910530100600505

Brandberg, Y., Sandelin, K., Erikson, S., Jurell, G., Liljegren, A., Lindblom, A., . . . Arver, B. (2008). Psychological reactions, quality of life, and body image after bilateral prophylactic mastectomy in women at high risk for breast cancer: A prospective 1-year follow-up study. Journal of Clinical Oncology, 26, 3943-3949. doi: 10.1200/JCO.2007.13.9568

Broadbent, E., Petrie, K. J., Main, J., & Weinman, J. (2006). The Brief Illness Perception Questionnaire. Journal of Psychosomatic Research, 60, 631-637. doi: 10.1016/j.jpsychores.2005.10.020

Buick, D. L. (1997) Illness representations and breast cancer: coping with radiation and chemotherapy. In K. J. Petrie & J. A. Weinman (Eds.), Perceptions of health and illness (pp. 379-410). Amesterdam: Harwood Academic Publishers.

Burgess, C., Cornelius, V., Love, S., Graham, J., Richards, M., & Ramirez, A. (2005). Depression and anxiety in women with early breast cancer: Five year observational cohort study. British Medical Journal, 330, 702-705.

Bustreo, F., & Chestnov, O. (2015). A month to remember – Breast cancer awareness month. World Health Organization. http://www.who.int/mediacentre/factsheets/fs297/en/

Çam, O., Saka, Ş., & Gümüş, A. B. (2009). İnvestigation of factors affecting psychosocial adjustment of patients with breast cancer. Journal of Breast Health, 5, 73-81.

Cardoso, M. J., Oliveira, H., & Cardoso, J. (2014). Assessing cosmetic results after breast conserving surgery. Journal of Surgical Oncology, 110, 37-44. doi: 10.1002/jso.23596

Cohen, L., Hack, T. F., Moor, C., Katz, J., & Goss, P. E. (2000). The effects of type surgery and time on psychological adjustment in women after breast cancer treatment. Annals of surgical Oncology, 7, 427-434. doi: 10.1007/s10434-000-0427-9

Crist, J. V., & Grunfeld, E. A. (2013). Factors reported to influence fear of recurrence in cancer patients: A systematic review. Psyco-Oncology, 22, 978-986. doi: 10.1002/pon.3114

Denewer, A., Farouk, O., & Elshamy, K. (2011). Social support and hope among Egyptian women with breast cancer after mastectomy. Breast Cancer: Basic and Clinical Research, 5, 93. doi: 10.4137/BCBCR.S6655

Dias, M. R. (2002). Cancro da mama: A (contra) informação dos mass media. In M. R. Dias & E. Duá (Coords.), Territórios da Psicologia Oncológica (pp. 235-264). Lisboa: Climepsi Editores.

Dubashi, B., Vidhubala, E., Cyriac, S., & Sagar, T. G. (2010). Quality of life among young women with breast cancer: Study from a tertiary cancer institute in south India. Indian Journal of Cancer, 47, 142-147. doi: 10.4103/0019-509X.63005

Fafouti, M., Paparrigopoulos, T., Zervas, Y., Rabavilas, A., Malamos, N., Liappas, I., & Tzavara, C. (2010). Depression, anxiety and general psychopathology in breast cancer patients: A cross-sectional control study. In Vivo, 24, 803-810.

Ferlay, J., Steliarova-Foucher, E., Lortet-Tieulent, J., Rosso, S., Coebergh, J. W. W., Comber, H., . . . Bray, F. (2013). Cancer incidence and mortality patterns in Europe: Estimates for 40 countries in 2012. European Journal of Cancer, 49, 1374-1403. doi: 10.1016/j.ejca.2012.12.027

Fonseca, S., Lencastre, L., & Guerra, M. (2014). Life satisfaction in women with breast cancer. Paidéia (Ribeirão Preto), 24, 295-303. doi: 10.1590/1982-43272459201403

Ganz, P. A., Desmond, K. A., Leedham, B., Rowland, J. H., Meyerowitz, B. E., & Belin, T. R. (2002). Quality of life in long-term, disease free survivors of breast cancer: A follow-up study. Journal of the National Cancer Institute, 94, 39-49. doi: 10.1093/jnci/94.1.39

Gouveia, J. L. R. V. (2004). Diferenças a nível de género na adaptação psicossocial a curto prazo no pós enfarte agudo do miocárdio. Dissertação de Mestrado na área de especialização de Psicologia da Saúde apresentada à Universidade do Minho.

Härtl, K., Janni, W., Kästner, R., Sommer, H., Strobl, B., Rack, B., & Stauber, M. (2003). Impact of medical and demographic factors on long-term quality of life and body image of breast cancer patients. Annals of oncology, 14, 1064-1071. doi: 10.1093/annonc/mdg289

Hoover, S., Bloom, E., & Patel, S. (2011). Review of breast conservation therapy: Then and now. ISRN Oncology, 2011. http://dx.doi.org/10.5402/2011/617593

Hwang, S. Y., Chang, S. J., & Park, B. (2013). Does chemotherapy really affect the quality of life of women with breast cancer?. Journal of Breast Cancer, 16, 229-235. http://dx.doi.org/10.4048/jbc.2013.16.2.229

Kaklamani, V. G., & Gradishar, W. J. (2005). Adjuvant therapy of breast cancer. Cancer Investigation, 23, 548-560. http://dx.doi.org/10.1080/07357900500202937

Leventhal, H., Benyamnini, Y., Brownlee, S., Diefenbach, M., Leventhal, E. A., Patrick-Miller, & Robitaille, C. (1997). Illness representations: Theoretical foundations. In K. J. Petrie & J. A. Weinman (Eds.), Perceptions of Health & Illness (pp. 19-45). Amsterdam: Harwood Academic Publishers.

Markopoulos, C., Tsaroucha, A. K., Kouskos, E., Mantas, D., Antonopoulou, Z., & Karvelis, S. (2009). Impact of breast cancer surgery on the self-esteem and sexual life of female patients. Journal of International Medical Research, 37, 182-188. doi: 10.1177/147323000903700122

Mclntyre, T., Pereira, M. G., Soares, V., Gouveia, J., & Silva, S. (1999). Escala de Ansiedade e de Depressão Hospitalar. Versão Portuguesa de Investigação. Braga, Portugal: Departamento de Psicologia, Universidade do Minho.

McIntyre, T., McIntyre, S., & Soares, V. (2000). Versão Portuguesa do SIP – Sickness Impact Profile. Não publicado.

Medeiros, M. C., Veiga, D. F., Sabino Neto, M., Abla, L. E. F., Juliano, Y., & Ferreira, L. M. (2010). Depression and conservative surgery for breast cancer. Clinics, 65, 1291-1294. http://dx.doi.org/10.1590/S1807-59322010001200011

Metcalfe, K. A., Semple, J., Quan, M. L., Vadaparampil, S. T., Holloway, C., Brown, M., . . . Narod, S. A. (2012). Changes in psychosocial functioning 1 year after mastectomy alone, delayed breast reconstruction, or immediate breast reconstruction. Annals of Surgical Oncology, 19, 233-241. doi: 10.1245/s10434-011-1828-7

Metcalfe, K. A., Zhong, T., Narod, S. A., Quan, M. L., Holloway, C., Hofer, S., . . . Semple, J. (2015). A prospective study of mastectomy patients with and without delayed breast reconstruction: Long-term psychosocial functioning in the breast cancer survivorship period. Journal of Surgical Oncology, 111, 258-264. doi: 10.1002/jso.23829

Millar, K., Purushotham, A., McLatchie, E., Georges, W. D., & Murray, G. D. (2005). A 1-year prospective study of individual variation in distress, and illness perceptions, after treatment for breast cancer. Journal of Psychosomatic Research, 58, 335-342.

Miller, S. L.B., Jones, L. E., & Carney, C. P. (2005). Psychiatric sequele following breast cancer chemotherapy: A pilot Study using claims data. Psychosomatics, 46, 517-522. http://dx.doi.org/10.1176/appi.psy.46.6.517

Moreira, H., & Canavarro, M. C. (2012). Tipo de cirurgia, adaptação psicossocial e imagem corporal no cancro da mama. Psicologia, Saúde & Doenças, 13, 169-190.

Nakatani, Y., Iwamitsu, Y., Kuranami, M., Okazaki, S., Yamamoto, K., Watanabe, M., & Miyaoka, H. (2013). Predictors of psychological distress in breast cancer patients after surgery. Kitasato Medical Journal, 43, 49-56.

Nava, M. B., Rocco, N., & Catanuto, G. (2015). Conservative mastectomies: An overview. Gland Surgery, 4, 463-466. doi: 10.3978/j.issn.2227-684X.2015.04.06

Ominyi, J., & Nwodom, M. (2012). Psychological impact of mastectomy and breast reconstruction. International Journal of Science and Research (IJSR), 3, 551-556.

Parker, P. A., Youssef, A., Walker, S., Basen-Engquist, K., Cohen, L., Gritz, E. R., . . . Robb, G. L. (2007). Short-term and long-term psychosocial adjustment and quality of life in women undergoing different surgical procedures for breast cancer. Annals of Surgical Oncology, 14, 3078-3089. doi: 10.1245/s10434-007-9413-9

Petrie, K. J., & Weinman, J. A. (1997). Perceptions of Health and Illness. In K. J. Petrie & J. A. Weinman (Eds.), Perceptions of health and ilness (pp. 1-46). Amesterdam: Harwood Academic Publishers.

Rebelo, V., Rolim, L., Carqueja, E., & Ferreira, S. (2007). Avaliação da qualidade de vida em mulheres com cancro de mama: Um estudo exploratório com 60 mulheres portuguesas. Psicologia, Saúde & Doenças, 8, 13-32.

Saita, E., Acquati, C., & Kayser, K. (2015). Coping with early stage breast cancer: Examining the influence of personality traits and interpersonal closeness. Frontiers in Psychology, 6, 88. doi: 10.3389/fpsyg.2015.00088

Schwartz, G. F., Veronesi, U., Clough, K. B., Dixon, J. M., Fentiman, I. S., Heywang-Köbrunner, S. H., . . . Palazzo, J. P. (2007). Consensus conference on breast conservation. In Seminars in Breast Disease (Vol. 10, No. 4, pp. 178-185). WB Saunders.

Shrestha, K. (2012). Psychological impact after mastectomy among Nepalese women: A qualitative study. Nepal Medical College Journal, 14, 153-156.

Silva, G. D., & Santos, M. A. D. (2010). Stressors in breast cancer post-treatment: A qualitative approach. Revista Latino-Americana de Enfermagem, 18, 688-695. doi: 10.1590/S0104-11692010000400005

Skrzypczak, M., Łaski, P., Czerniak, U., & Kycler, W. (2009). Do chronological age and selected socio-demographic factors affect quality of life in females with breast cancer?. Anthropological Review, 72, 31-44. doi: 10.2478/v10044-008-0014-4

Trovisqueira, A. (2007). Impacto de uma intervenção informativa baseada na teoria das cognições de doença, em doentes no pós-enfarte do miocárdio. Tese de Mestrado, Universidade do Minho.

Ursaru, M., Crumpei, I., & Crumpei, G. (2014). Quality of life and religious coping in women with breast cancer. Procedia Social and Behavioral Sciences (ISI Proceedings), 114, 322-326. doi: 10.1016/j.sbspro.2013.12.705

Vahdaninia, M., Omidvari, S., & Montazeri, A. (2010). Social Psychiatry Epidemiology, 45, 355. doi: 10.1007/s00127-009-0068-7

van den Berg, S. W., Gielissen, M. F., Custers, J. A., van der Graaf, W. T., Ottevanger, P. B., & Prins, J. B. (2015). BREATH: web-based self-management for psychological adjustment after primary breast cancer – Results of a multicenter randomized controlled trial. Journal of Clinical Oncology, 33, 2763-2771. doi: 10.1200/JCO.2013.54.9386

Vargas, S., Wohlgemuth, W. K., Antoni, M. H., Lechner, S. C., Holley, H. A., & Carver, S. C. (2010). Sleep dysfunction and psychosocial adaptation among women undergoing treatment for non-metastatic breast cancer. Psycho-Oncology, 19, 669-673. doi: 10.1002/pon.1603

Veiga, D. F., Campos, F. S. M., Ribeiro, L. M., Archangelo Junior, I., Veiga Filho, J., Juliano, Y., . . . Ferreira, L. M. (2010). Mastectomy versus conservative surgical treatment: the impact on the quality of life of women with breast cancer. Revista Brasileira de Saúde Materno Infantil, 10, 51-57. doi: 10.1590/S1519-38292010000100005

Yurek, D., Ferrar, W., & Andersen, B. L. (2000). Breast cancer surgery: Comparing surgical groups and determining individual differences in postoperative sexuality and body change stress. Journal of Consulting and Clinical Psychology, 68, 697-709. http://dx.doi.org/10.1037/0022-006X.68.4.697

Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361-370. doi: 10.1111/j.1600-0447.1983.tb09716.x




DOI: https://doi.org/10.14417/ap.1205

Refbacks

  • There are currently no refbacks.


Nº ERC: 107494 | ISSN (in print): 0870-8231 | ISSN (online): 1646-6020 | Copyright © ISPA - CRL, 2012 | Rua Jardim do Tabaco, 34, 1149-041 Lisboa | NIF: 501313672 | The portal and metadata are licensed under the license Creative Commons CC BY-NC