The emotional impact of mastectomy

To learn about the effects of unilateral mastectomy, the emotional responses of four groups of women were compared 1-3 and 10-12 months after surgery: (1) mastectomy group (n = 125)--women who had a unilateral mastectomy for stage I or II breast cancer; (2) biopsy group (n = 65)--women who had a biopsy revealing benign breast disease; (3) cholecystectomy group (n = 75)--women who had a cholecystectomy; (4) healthy group (n = 84)--women who had not had a major surgical intervention. Measures of emotions were: (1) the SCL-90 Analogue; (2) the Global Assessment Scale (GAS); and (3) the Gottschalk-Gleser Content Analysis Scale. The mastectomy group had significantly higher mean Gottschalk-Gleser scores for total anxiety, death and mutilation anxiety, ambivalent hostility, total denial and anxiety denial, and hopefulness. Significant reductions were found in mean total anxiety, mutilation, and shame anxiety in the mastectomy group and in total, death, and mutilation anxiety in the cholecystectomy group between the two postsurgical assessments. The mastectomy group had a significantly higher mean anxiety and depression score than the healthy group on the SCL-90 at both time points. The mastectomy and cholecystectomy groups had lower emotional well-being scores on the GAS than the healthy group over both testing periods. The groups also differed in their amount of change on the GAS over time. All measures, especially the Gottschalk-Gleser scales, showed significantly more psychopathological emotional responses in the mastectomy group, somewhat less in the cholecystectomy group, and the least in the biopsy group.