Psychological and social adjustment to mastectomy: a two-year follow-up study

A consecutive series of 160 women admitted to hospital for breast tumor biopsy was assessed prior to, and at 3, 12, and 24 months following operation for marital, sexual, interpersonal and work adjustment, depression, and personality characteristics by means of rating scales based on structures interviews and standard tests. By 2 years there wery no significant differences in social adjustment between mastectomy patients and benign breast disease controls; 70% of cancer patients were no longer stressed by mastectomy at 1 year. Factors predicting poor adjustment to mastectomy were high preoperative scores on the Hamilton Rating Scale for Depression and the Neuroticism Scale of the Eysenck Personality Inventory; deterioration in sexual adjustment was associated with biological or chronological perimenopausal status. Significantly more cancer than benign disease patients were dissatisfied with the information they received about operation and diagnosis. Implications of these findings for the care of the mastectomy patient are discussed.