Symptoms-Related Distress among Patients Receiving Adjuvant Therapy: Radical Mastectomy versus Lumpectomy

Abstract

Background: Breast cancer is the most common cancer in women worldwide. Although adjuvant therapy after breast-conserving surgery or mastectomy reduces the risk of breast cancer coming back but it induces many of physiological and psychological effects. The aim of the current study was to compare the Symptoms-related distress among patients receiving adjuvant therapy: Radical Mastectomy versus Lumpectomy at a University Hospital. Research Questions: Q1: What are the symptoms related distresses among radical mastectomy and lumpectomy patients receiving adjuvant therapy? Q2: Is there a difference in symptoms related distress between radical mastectomy and lumpectomy patients receiving adjuvant therapy? Design: A comparative descriptive -non-experimental design was utilized to achieve the aim of the current study. Tools: I) Socio-demographic and medical data sheet: It included data related to the studied subjects such as age, gender, marital status, types of received chemotherapy,…..etc. Tool II: Rotterdam Symptom Checklist (RSCL); it is useful in measuring the symptoms reported by cancer patients. It aims to enhance the insight into the consequences of the disease and its treatment. Setting: The study was conducted at the Nuclear Medicine Unit at Kasr Al-Aini Educational Hospital; affiliated to Cairo-University-Egypt. Subjects: A convenient sample of 60 adult female patients divided into two equal groups, patients with radical mastectomy (n=30) and patients with lumpectomy (n=30) both groups received chemotherapy after surgery. Results: 80% of mastectomy and lumpectomy cases overall their age was between 40 and less than 60 years old. 33.3% of the study sample can read and write. The study pointed out that 48.3% of the sample had breast cancer between 2 and less than 6 months. While 50% of them between 6 to less than 12 months with Mean+SD= 5.65+2.There was a perfect correlation between total score of RSCL and physical total score =0.826, 0.829 & 0.828 for patients overall cases, mastectomy cases only & lumpectomy cases only respectively. Also there was a strong correlation between the RSCL total score and psychological total score=0.705, 0.747 & 0.668 for the patients overall cases, mastectomy cases only & lumpectomy cases only respectively. Conclusion: The lumpectomy cases scored generally their physical, psychological & activity level impairment status much better than the mastectomy cases. Also lumpectomy cases their general QOl was better than the mastectomy cases. Recommendation of the study: 1-More close physical, psychological support must endorse in nursing care for patients with mastectomy. 2-QOL advanced tool is recommended on survey scale to evaluate patients' condition with mastectomy & lumpectomy. 3-All patients with breast cancer must join a rehabilitation program before & after proceed in either mastectomy or lumpectomy surgical management.

Keywords: Adjuvant therapy, Mastectomy, lumpectomy, symptoms related distress.