section name header

Evidence summaries

Quality of Life after Breast Conservation or Mastectomy

Psychological outcomes, particularly for body image, are moderately better after breast-conserving surgery compared to mastectomy. Level of evidence: "A"

A systematic review 1 including 6 RCTs with a total of 682 subjects was abstracted in DARE. Women with breast conservation has a more favourable body image of themselves than those who had mastectomy in all five studies in which it was examined (p=0.03). The evidence was statistically inconclusive for all other dimensions measured, namely perceptions of psychological health, sexual health, physical health, fear of the future, and global quality of life.

Another systematic review 2 including 40 controlled studies with a total of 4,461 subjects was abstracted in DARE. The weighted effect sizes for psychological (mean = 0.118, SD = 0.039, p<0.019, marital-sexual (mean = 0.093, SD = 0.048), social adjustment (mean = 0.181, SD = 0.073m p<0.01), body/self image (mean = 0.4, SD = 0.043, p<0.00001) and cancer-related fears and concerns (mean = 0.161, SD = 0.063, p<0.0001) favoured breast-conserving surgery over mastectomy.

    References

    • Irwig L, Bennetts A. Quality of life after breast conservation or mastectomy: a systematic review. Aust N Z J Surg 1997 Nov;67(11):750-4. [PubMed][DARE]
    • Moyer A. Psychosocial outcomes of breast-conserving surgery versus mastectomy: a meta-analytic review. Health Psychol 1997 May;16(3):284-98. [PubMed][DARE]

Primary/Secondary Keywords