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Psychiatric problems in the first year after mastectomy.

G P Maguire, E G Lee, D J Bevington

    British Medical Journal
    |April 15, 1978
    PubMed
    Summary
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    Women undergoing mastectomy experienced higher rates of psychiatric issues, including anxiety, depression, and sexual difficulties, compared to controls. Early identification and intervention are crucial for improving patient outcomes after breast cancer surgery.

    Area of Science:

    • Psychiatry
    • Oncology
    • Women's Health

    Background:

    • Mastectomy, a common surgical procedure for breast cancer, can significantly impact a woman's psychological well-being.
    • Previous studies suggest a link between mastectomy and psychiatric morbidity, but comprehensive follow-up data is often limited.

    Purpose of the Study:

    • To assess the incidence and severity of psychiatric morbidity in women following mastectomy.
    • To compare the psychological outcomes of mastectomy patients with a control group having benign breast disease.
    • To evaluate the appropriateness of help received by patients experiencing emotional distress.

    Main Methods:

    • A prospective study followed 75 women undergoing mastectomy from presentation of suspected breast cancer to one year post-operation.

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  • Fifty women with benign breast disease served as a control group.
  • Psychiatric problems, including anxiety, depression, and sexual difficulties, were assessed throughout the follow-up period.
  • Main Results:

    • Women who underwent mastectomy showed a higher incidence of psychiatric problems compared to controls.
    • One year post-surgery, 25% of mastectomy patients required treatment for anxiety/depression versus 10% of controls.
    • Moderate to severe sexual difficulties were reported by 33% of mastectomy patients compared to 8% of controls.
    • Overall, 39% of mastectomy patients experienced serious anxiety, depression, or sexual difficulties, compared to 12% of controls.

    Conclusions:

    • Mastectomy is associated with significant and persistent psychiatric morbidity, including anxiety, depression, and sexual dysfunction.
    • There is a notable gap in recognizing and adequately treating the emotional distress experienced by women post-mastectomy.
    • Implementing monitoring by specialized nurses and social workers could improve early identification and management of these psychological issues.