Chinese breast cancer patients: psychological outcome differences between patients who had mastectomy or lumpectomy treatment

Abstract

OBJECTIVE: In Hong Kong, surgery and adjuvant treatments (mainly chemotherapy and radiotherapy) are the standard treatment for breast cancer patients. Although the choice of lumpectomy and mastectomy surgery which related to the preservation of the breast had huge psychological influence on patients, less is known on the difference. This study aims at investigating the difference on psychological outcome of mastectomy versus lumpectomy among Chinese breast cancer patients. DESIGN: 140 Chinese breast cancer patients who had completed the mastectomy or lumpectomy surgery were recruited in this study. All of them were asked to fill in a set of self-reported questionnaires including fatigue, emotional distress (anxiety and depression), pain, sleeping quality and quality of life scale before their commencement of radiotherapy treatment. METHODS: Independent sample t-test had been conducted to investigate the difference on psychological outcomes among breast cancer patients undergo different surgery. RESULTS: 61 per cent of participants had lumpectomy and 39 per cent (55 participants) had total mastectomy surgery. Result showed that patient had lumpectomy surgery in general had better psychological outcome than patient had mastectomy. They had significant difference on the functional well-being domain in Quality of Life scale (t(137) = -2.368; p <.05). CONCLUSIONS: Breasts are an important part of women’s sexual identity. Removing part or whole of the breast would affect patient’s perception of identity and psychological well-being. In Hong Kong, women still found breast cancer as a taboo. Our research found out that breast cancer patients who underwent different breast removal surgery had different viewpoints on their daily living functioning ability. Functional well-being is highly related to the recovery process of breast cancer patients. It may relate to how patients constructed their self-image and self-identity. Clinician and practitioner must be alert on the influences on different cancer treatments on patients.