The impact of breast-conserving treatment and mastectomy on the quality of life of early-stage breast cancer patients: a review.

In recent years, doubt has been shed on the necessity of mastectomy for women with early-stage breast cancer. Apart from purely medical studies comparing (radical) mastectomy to less intruding surgical treatment, a number of studies (N = 18) have been published investigating the impact of breast-conserving treatment versus mastectomy on quality of life. We review these studies with respect to medical issues (treatment modality, stage of disease), methodologic issues (design, measurement moment, sample size), and results (psychologic discomfort, changes in life patterns, fears and concerns). It is concluded that there is no solid proof of a better psychologic adjustment after breast-conserving treatment and that there are no substantial differences between the different treatment modalities in changes of life patterns and fears and concerns. However, the results with respect to body image and sexual functioning favor the use of breast-conserving treatment.