RESUMO
In a retrospective analysis of 197/600 women (33%) treated for primary breast cancer at the Department of Obstetrics and Gynecology at the University of Münster (1984 to 1994) the psycho-social acceptance of mastectomy vs. breast conservative treatment (BET) was evaluated. Mean age was 59 years (range, 31-87 yrs.). BET was performed in 58% (n = 114), modified radical mastectomy (MRM) in 42% (n = 83). Reconstructive surgery after MRM was performed in 40% (n = 33) either as primary procedure in 39% (n = 14) or as secondary procedure in 61% (n = 20). In addition to somatic patterns, features of pre- and postoperative coping, individual psycho-social burden, cosmetic results, contentment of treatment, social rehabilitation and quality of life were evaluated. Performance status and quality of human relations are discussed. In terms of psycho-social acceptance the results of BET are in general not superior to MRM at a mean follow-up of six years. Coping and postoperative quality of life are almost similar within the two groups. Although the alteration of body image after BET is less compared to MRM, the psychologic burden of postoperative radiotherapy and the fear of local recurrence are experienced worst compared to all other features analyzed after BET.
