Psychological outcomes of different treatment policies in women with early breast cancer outside a clinical trial.

摘要: OBJECTIVES--To assess outside a clinical trial the psychological outcome of different treatment policies in women with early breast cancer who underwent either mastectomy or conservation surgery depending on surgeon's opinion patient's choice. To determine whether extent psychiatric morbidity reported was associated their participation randomised trial. DESIGN--Prospective, multicentre study capitalising individual and motivational differences among patients management surgeons for treating cancer. SETTING--12 District general hospitals, three London teaching four private hospitals. PATIENTS--269 Women under 75 probable diagnosis stage I II were referred to 22 surgeons. INTERVENTIONS--Surgery radiotherapy adjuvant chemotherapy, both, stated preferences managing MAIN OUTCOME MEASURES--Anxiety depression as assessed by standard methods two weeks, months, 12 months after surgery. RESULTS--Of 269 women, 31 treated favoured mastectomy, 120 conservation, 118 offered choice treatment. Sixty eligible choose surgery, 43 these chose conserving The incidences anxiety, depression, sexual dysfunction high all groups. There no significant anxiety between those lumpectomy. A effect surgeon type incidence observed, showing less than other (p = 0.06). difference same group not able choose. Most (159/244) gave fear primary rather losing breast. overall lumpectomy similar found Cancer Research Campaign study. At 28% present anxious compared 26% earlier study, 27% 31% In both 21% depressed, 19% depressed study.) CONCLUSIONS--There is still evidence that undergo have mastectomy. surrender autonomy decision making agreeing participate trials do experience any psychological, sexual, social problems from are