Psychiatric management of patients with breast cancer, as well as women's emotional reactions to all phases of breast cancer, were reviewed. These patients face two major losses; one is the physical loss of part of the body and a threat to life, and the other is the loss of femininity. The patients are also likely to suffer from various psychiatric problems including anxiety and depression. Oncologists should be alert to each patient's emotional reactions and potential psychiatric problems, and if necessary, should refer them to a psychiatrist. A combination of psychotherapeutic, behavioural, and pharmacologic techniques is available for the care of patients with breast cancer. Psychotherapeutic modalities include individual therapy, family therapy, group therapy, and self-help treatment. The author divided individual therapy into general and specific treatment. General treatment deals with a crisis-intervention and cognitive-behavioral approach, whereas specific treatment deals with issues relevant to patients with breast cancer. Some of the therapeutic processes were illustrated in a case report. These guidelines will contribute to the relief and prevention of emotional suffering stemming from an encounter with the most common form of cancer in women. Also, proper and effective care for patients with breast cancer requires combined use of a variety of therapeutic modalities as well as a multi-disciplinary approach including psychiatric care.
Breast Neoplasms/therapy ; Breast Neoplasms/psychology* ; Family ; Female ; Human ; Neoplasm Recurrence, Local/psychology ; Patient Education ; Psychotherapy, Group ; Self-Help Groups

Objective: To explore the dynamic changes of Distress Thermometer scores and the relationship between psychological distress and quality of life in Chinese early breast cancer patients during chemotherapy. Methods: This prospective study enrolled 110 Chinese postoperative early breast cancer patients between March 2019 and December 2019. The psychological distress and quality of life (QOL) of patients were assessed by using the psychological distress management screening tool and the patient quality of life scale. Logistic regression model was used to analyze the influencing factors of psychological distress degree. The correlation between distress thermometer (DT) score changes and quality of life was analyzed by Pearson correlation analysis. Results: In total, 96 valid cases were analyzed. Before chemotherapy, 47 cases (49.0%) had DT score ≥4 points. After 2 cycles of chemotherapy, 40 cases (41.7%) had DT score ≥4 points. Thirty-four patients (35.4%) had DT score ≥4 points after chemotherapy. The DT score after chemotherapy was lower than that before chemotherapy and after 2 cycles of chemotherapy. Univariate analysis showed that income level and pathological stage were still significant related to the detection of DT score ≥4 points after chemotherapy (P<0.05). The changes of DT scores before and after chemotherapy were negatively correlated with the changes of quality of life ( r=-0.298, P=0.003). Conclusions: The detection rate of psychological distress in patients with early breast cancer during chemotherapy showed a decreasing trend. Income level and tumor stage are significant factors affecting the psychological distress of patients. There is a significant correlation between the psychological distress and the quality of life during chemotherapy. We should pay attention to the evaluation and monitoring state of psychological distress of patients during chemotherapy.
Humans ; Female ; Quality of Life/psychology* ; Breast Neoplasms/psychology* ; Stress, Psychological/psychology* ; Prospective Studies ; Psychological Distress ; China ; Neoplasms ; Surveys and Questionnaires

OBJECTIVETo investigate the optimal time to perform breast reconstruction after mastectomy for breast cancer.

METHODSFrom May, 2001 to March, 2004, 52 patients were performed immediate or delayed breast reconstruction after mastectomy. They were given questionnaires to assess for satisfaction, sexuality, anxiety, depression, body image and self-esteem.

RESULTS97% of the IR group patients were very or moderately satisfied while only 75% of the DR group were so (P = 0.026). Only 6% of the IR group compared with 30% of the DR group felt an obvious impairment of their sexual attractiveness (P = 0.043). Anxiety (P = 0.014) and depression (P = 0.006) were less in the IR group than the DR group. Body image (P = 0.012) and self-esteem (P = 0.003) were superior in the IR group.

CONCLUSIONSIf tumor characters and patient health permit, immediate breast reconstruction should be performed after mastectomy for breast cancer.

Adult ; Breast Neoplasms ; psychology ; surgery ; Female ; Humans ; Mammaplasty ; methods ; psychology ; Middle Aged

Oncoplastic surgery has revolutionized the field of breast conserving surgery (BCS). The final aims of this technique are to obtain an adequate resection margin that will reduce the rate of local recurrence while simultaneously improving cosmetic outcomes. To obtain successful results after oncoplastic surgery, it is imperative that patients be risk-stratified based on risk factors associated with positive margins, that relevant imaging studies be reviewed, and that the confirmation of negative margins be confirmed during the initial operation. Patients who had small- to moderate-sized breasts are the most likely to be dissatisfied with the cosmetic outcome of surgery, even if the defect is small; therefore, oncoplastic surgery in this population is warranted. Reconstruction of the remaining breast tissue is divided into volume displacement and volume replacement techniques. The use of the various oncoplastic surgeries is based on tumor location and excised breast volume. If the excised volume is less than 100 g, the tumor location is used to determine which technique should be used, with the most commonly used technique being volume displacement. However, if the excised volume is greater than 100 g, the volume replacement method is generally used, and in cases where more than 150 g is excised, the latissimus dorsi myocutaneous flap may be used to obtain a pleasing cosmetic result. The local recurrence rate after oncoplastic surgery was lower than that of conventional BCS, as oncoplastic surgery reduced the rate of positive resection margins by resecting a wider section of glandular tissue. If the surgeon understands the advantages and disadvantages of oncoplastic surgery, and the multidisciplinary breast team is able to successfully collaborate, then the success rate of BCS with partial breast reconstruction can be increased while also yielding a cosmetically appealing outcome.
Breast ; Breast Neoplasms ; Cosmetics ; Displacement (Psychology) ; Female ; Humans ; Precision Medicine ; Mammaplasty ; Mastectomy, Segmental ; Recurrence ; Risk Factors

PURPOSE: The purpose of this study was to evaluate the effects of meditation program on power, depression and Quality of Life (QoL) in women with breast cancer. METHODS: In this study Barrett's Power theory derived from Rogers' Unitary Human Being Paradigm was used as a theoretical framework. A randomized controlled design was used with 50 participants recruited and randomly allocated. The experimental group (n=20) received the 8-week meditation program. The control group (n=21) received the same program as the experimental group after completion of the first- and eighth-week questionnaires. Collected data were analyzed using SPSS for Windows. RESULTS: Results of homogeneity verification of preliminary investigation data showed that there were no significant differences between the experimental and control groups except for power scores. Compared with the control group, patients in the meditation treatment group showed significant improvement in scores for power (t=-6.07, p<.001) and QoL (t=-3.45, p=.001), a significant reduction in scores for anxiety (t=2.74, p=.009) and depression (t=2.20, p=.033). CONCLUSION: The present trial results demonstrate that the 8-week meditation program significantly reduced anxiety and depression, and improved power and QoL in patients with breast cancer. These results suggest that meditation has positive effects on power, emotion and QoL.
Anxiety* ; Breast Neoplasms* ; Breast ; Depression* ; Female ; Humans ; Meditation* ; Power (Psychology)* ; Quality of Life* ; Surveys and Questionnaires

PURPOSE: Sensory changes in the upper limb are complications of a mastectomy with immediate breast reconstruction with the treatment of breast cancer. The purpose of this study is to clarify whether immediate breast reconstruction worsens the sensory changes. METHODS: From March 2004 to December 2005, 20 patients who had a mastectomy with immediate breast reconstruction(reconstruction group) were compared with 23 patients who had a mastectomy alone(control group). All patients had stage I or II breast cancer. The sensory changes were assessed in a blind manner by one examiner that used light touch sensation, static two-point discrimination, pain, vibration, hot and cold temperature perception. The sensory changes were identified along the sensory dermatome for diagnosing the damaged nerves. The following factors and their relationship with the sensory changes were analyzed:age, complications, and the mastectomy method. RESULTS: There was no statistical difference in the static two-point discrimination, pain, vibration, hot and cold temperature perception between the two groups. However, the ability to recognize light touch was significantly better(p=0.045) in the reconstruction group than in the control group. The main site of sensory change was the proximal and medial portion of the upper limb in both groups. At these sites, the mean value of Semmes-Weinstein monofilament was 1.01g/ mm2(reconstruction group 0.82, control group 1.17) and 2-point discrimination was 51.74(converted to perfect score of 100; reconstruction group 42.50, control group 59.78). The total rate of early complications was found to be significantly lower(p=0.006) in the reconstruction group than in the control group. CONCLUSION: These findings suggest that an immediate breast reconstructive procedure following a mastectomy is as safe as or safer than a mastectomy alone with respect to postoperative sensory changes of the ipsilateral upper limb.
Breast ; Breast Neoplasms ; Cold Temperature ; Discrimination (Psychology) ; Female ; Humans ; Light ; Mammaplasty ; Mastectomy ; Sensation ; Upper Extremity ; Vibration

Despite the popularity of breast-conserving surgery (BCS), which constitutes 50-60% of all breast cancer surgeries, discussions regarding cosmetic results after BCS are not specifically conducted. The simple conservation of breast tissue is no longer adequate to qualify for BCS completion. The incorporation of oncological and plastic surgery techniques allows for the complete resection of local disease while achieving superior cosmetic outcome. Oncoplastic BCS can be performed in one of the following two ways: 1) volume displacement techniques and 2) volume replacement techniques. This study reports volume displacement surgical techniques, which allow the use of remaining breast tissue after BCS by glandular reshaping or reduction techniques for better cosmetic results. Thorough understanding of these procedures and careful consideration of the patient's breast size, tumor location, excised volume, and volume of the remaining breast tissue during the surgery in choosing appropriate patient and surgical techniques will result in good cosmetic results. Surgery of the contralateral breast may be requested to improve symmetry and may take the form of a reduction mammoplasty or mastopexy. The timing of such surgery and the merits of synchronous versus delayed approaches should be discussed in full with the patients. Because Korean women have relatively small breast sizes compared to Western women, it is not very easy to apply the oncoplastic volume displacement technique to cover defects. However, we have performed various types of oncoplastic volume displacement techniques on Korean women, and based on our experience, we report a number of oncoplastic volume displacement techniques that are applicable to Korean women with small- to moderate-sized breasts.
Breast ; Breast Neoplasms ; Cosmetics ; Displacement (Psychology) ; Female ; Humans ; Mammaplasty ; Mastectomy, Segmental ; Surgery, Plastic

Despite the popularity of breast-conserving surgery (BCS), which constitutes 50-60% of all breast cancer surgeries, discussions regarding cosmetic results after BCS are not specifically conducted. The simple conservation of breast tissue is no longer adequate to qualify for BCS completion. The incorporation of oncological and plastic surgery techniques allows for the complete resection of local disease while achieving superior cosmetic outcome. Oncoplastic BCS can be performed in one of the following two ways: 1) volume displacement techniques and 2) volume replacement techniques. This study reports volume displacement surgical techniques, which allow the use of remaining breast tissue after BCS by glandular reshaping or reduction techniques for better cosmetic results. Thorough understanding of these procedures and careful consideration of the patient's breast size, tumor location, excised volume, and volume of the remaining breast tissue during the surgery in choosing appropriate patient and surgical techniques will result in good cosmetic results. Surgery of the contralateral breast may be requested to improve symmetry and may take the form of a reduction mammoplasty or mastopexy. The timing of such surgery and the merits of synchronous versus delayed approaches should be discussed in full with the patients. Because Korean women have relatively small breast sizes compared to Western women, it is not very easy to apply the oncoplastic volume displacement technique to cover defects. However, we have performed various types of oncoplastic volume displacement techniques on Korean women, and based on our experience, we report a number of oncoplastic volume displacement techniques that are applicable to Korean women with small- to moderate-sized breasts.
Breast ; Breast Neoplasms ; Cosmetics ; Displacement (Psychology) ; Female ; Humans ; Mammaplasty ; Mastectomy, Segmental ; Surgery, Plastic

PURPOSE: A systematic literature review and meta-analysis were conducted to synthesis research findings on relationships of quality of life with multi-dimensional correlates in Korean breast cancer patients. METHODS: For the study purpose, 18 studies were selected through a systematic process of searching the literature. RESULTS: Among the general characteristics, variables having a significant relationship with quality of life were age (ES=.19), marital status (ES=.15), education (ES=.19), economic status (ES=.16), job status (ES=.10), and religion (ES=.13). Among the disease characteristics, type of treatment (ES=.12), length of time since diagnosis (ES=.13), stage of disease (ES=.14), length of time since operation (ES=.10), frequency of treatment (ES=.19), wound site and pain (ES=.16) were shown to have a significant relationship with quality of life. Depression (ES=-.60), one of the psychological factor, was the variable most significantly related to quality of life. CONCLUSION: The findings indicate that the variables which strongly impact quality of life in breast cancer patients are depression and pain.
Breast Neoplasms* ; Breast* ; Depression ; Diagnosis ; Education ; Humans ; Marital Status ; Psychology ; Quality of Life* ; Wounds and Injuries

Fine needle aspiration biopsy cytology (FNA) for diagnosis of a variety of breast tumors has been proven to be a simple, sate, and cost saving diagnostic methodology with high accuracy. Cytologic specimens from 1,029 fine needle aspirations of the breast during last 3-year period were reviewed and subsequent biopsies from 107 breast lesions were reevaluated for cytohistological correlation. FNA had a sensitivity of 81.6% and a specificity of 98.3%. One out of 107 cases biopsied revealed a false positive result (0.9%) and the case was due to misinterpretation of apocrine metaplastic cells in necrotic backgound as malignant cells. A false negative rate was 8.4% (9 of 107 cases biopsied). Six of 9 false negative cases were resulted from insufficient aspirates for diagnosis, and remaining three of 9 false negative cases revealed extensive necrosis with no or scanty viable cells on smears. The results indicate that for reducing false positive and false negative rates of FNA, an experienced cytopathologist and a proficient aspirator are of great importance.
Aspirations (Psychology) ; Biopsy* ; Biopsy, Fine-Needle* ; Breast Neoplasms* ; Breast* ; Cost Savings ; Diagnosis ; Necrosis ; Needles ; Sensitivity and Specificity