ABSTRACT
This important and controversial study was the first randomized trial designed to determine the psychological benefits of breast conserving surgery and radiotherapy compared with mastectomy. A total of 101 women with early (stage I or II) breast cancer who had expressed no strong preference for surgical treatment were randomized to either mastectomy or breast conservation. Psychiatric morbidity was assessed primarily via a standardized semi-structured interview (the Present State Examination). The mean time from operation to interview was 15.8 months (SD 7.25). According to DSM-III diagnostic criteria, 21% of the women with mastectomy had a depressive illness and 26% an anxiety state. Among the breast conservation group 27% had depression and 31% anxiety. Overall, an affective disorder of depression, anxiety or both was present in 33% of mastectomy patients and 38% of those treated with breast conserving techniques. Sexual dysfunction was also high, with 38% of previously sexually active women reporting a lack of sexual interest post-surgery.
