背景:高风险患者建议进行降低风险的乳房切除术,但可能会产生重大的心理后果。这项研究旨在确定焦虑的差异,抑郁症状,在接受降低风险的乳房切除术前后,乳腺癌风险增加的女性的身体形象和生活质量。
方法:88名因BRCA1/2突变或先前诊断为癌症而增加患乳腺癌风险的女性参与了这项研究。使用的仪器是医院焦虑和抑郁量表,身体形象量表和欧洲癌症研究和治疗组织生活质量问卷核心30和乳房23,在手术前后15-30天进行。
结果:手术后,焦虑立即显著恶化,抑郁症状和身体形象。在全球范围内出现了显著的恶化,物理,角色,和社会功能,以及在身体形象和性享受尺度上。此外,疲劳增加了,恶心和呕吐,便秘,呼吸困难,失眠,食欲减退,感知到的财务困难,疼痛,全身治疗副作用,乳房和手臂症状。然而,未来的前景有所改善。这些变化的发生与参与者是否有癌症诊断或BRCA1/2突变无关。
结论:降低风险的乳房切除术具有直接的心理后果。虽然这些程序改善了未来的健康前景,它们增加了焦虑和抑郁症状,降低了身体形象和生活质量,无论癌症诊断或BRCA1/2突变。这些发现强调了这种外科手术的心理后果,强调需要在手术前后进行全面的心理干预。
BACKGROUND: Risk-reducing mastectomy is recommended for high-risk patients but may have significant psychological consequences. This study aimed to determine the differences in anxiety, depressive symptomatology, body image and quality of life in women with an increased risk of breast cancer immediately before and after undergoing risk-reducing mastectomy.
METHODS: Eighty-eight women with an increased risk of breast cancer due to BRCA1/2 mutations or a previous cancer diagnosis participated in this study. Instruments used were the Hospital Anxiety and Depression Scale, Body Image Scale and the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire Core 30 and Breast 23, administered 15-30 days before and after surgery.
RESULTS: Following surgery, there was an immediate and significant worsening in anxiety, depressive symptomatology and body image. There was a significant deterioration in global, physical, role, and social functioning, as well as in body image and sexual enjoyment scales. Additionally, there were increases in fatigue, nausea and vomiting, constipation, dyspnoea, insomnia, appetite loss, perceived financial difficulties, pain, systemic therapy side effects, and breast and arm symptoms. However, there was an improvement in future perspective. These changes occurred independently of whether participants had a cancer diagnosis or BRCA1/2 mutation.
CONCLUSIONS: Risk-reducing mastectomies have immediate psychological consequences. While these procedures improve future health perspective, they increase anxiety and depressive symptomatology and decrease body image and quality of life, regardless of cancer diagnosis or BRCA1/2 mutation. These findings highlight the psychological consequences of such surgical procedures, emphasizing the need for comprehensive psychological interventions both before and after surgery.