Psychosocial adjustment after treatment for early breast cancer

Psychosocial and sexual disturbances are common sequelae to a diagnosis of breast cancer and its treatment. The hope that the development of breast-conserving techniques would protect women from the psychological distress experienced after mastectomy has not been realized. Studies comparing the psychosocial outcome of mastectomy with lumpectomy and radiotherapy reveal an advantage of the breast-conservation groups in terms of body image, but little difference in terms of psychiatric morbidity. Whatever the primary therapy, women still have to confront the fact that they have had cancer, a life-threatening disease which may recur. It is therefore most important that, irrespective of the treatment offered, we improve our understanding of the premorbid personality characteristics and sociodemographic factors that may predispose certain women to failure of adjustment following a diagnosis of breast cancer.