• Ahmed Abdelatif Alexandria University of Medicine, Alexandria, Egypt & Alexandria Main University Hospital, Alexandria, Egypt
  • Galal Abounaggah Alexandria University of Medicine, Alexandria, Egypt & Alexandria Main University Hospital, Alexandria, Egypt
  • Mohamed Elmesery Alexandria University of Medicine, Alexandria, Egypt & Alexandria Main University Hospital, Alexandria, Egypt
  • Mohamed Asal Alexandria University of Medicine, Alexandria, Egypt & Alexandria Main University Hospital, Alexandria, Egypt
  • Moataz Eweda Alexandria University of Medicine, Alexandria, Egypt & Alexandria Main University Hospital, Alexandria, Egypt
Keywords: breast cancer, conservative treatment, mastectomy, psychological impact


The previous research on breast cancer's psychological impact was based on its effects on shape, with breast removal, and the subsequent effect on sexual attractiveness. Several changes that affect life behavior after breast cancer surgery including insomnia, difficulty returning to usual activities and work, nightmares and loss of appetite. These manifestations may be due to depression but they are only considered abnormal if they persist after the period of physical recovery from surgery. We conducted a study to assess the effects of the surgical decision and psychological impact of this decision on Egyptian females with breast cancer. Most patients were subjected to a questionnaire including all environmental and clinical factors affecting the surgical decision either mastectomy or breast-conserving surgery. As a conclusion we can say that breast conservative surgery is better accepted psychologically by patients than modified radical mastectomy as it did not affect sexual life, cosmetic appearance, mood, self-satisfaction, and quality of life.


[1] Halsted WS. A clinical and histological study of certain adenocarcinomata of the breast: and a brief consideration of the supraclavicular operation and of the results of operations for cancer of the breast from 1889 to 1898 at the Johns Hopkins Hospital. Ann Surg 1898; 28:557-76.
[2] Sakorafas GH. The origins of radical mastectomy. AORN J 2008; 88(4):605-8.
[3] TothBA, Lappert P. Modified skin incisions for mastectomy: the need for plastic surgical input in preoperative planning. PlastReconstrSurg 1991; 87(6):1048-53.
[4] Freeman BS. Subcutaneous mastectomy for benign breast lesions with immediate or delayed prosthetic replacement.PlastReconstrSurg 1962; 30:676-82.
[5] Okamura M, Yamawaki S, Akechi T, Taniguchi K, Uchitomi Y. Psychiatric disorders following first breast cancer recurrence: prevalence, associated factors and to quality of life. Jpn J ClinOncol 2005; 35:302-9.
[6] Han J, Grothuesmann D, Neises M, Hille U, Hillemanns P. Quality of life and satisfaction after breast cancer operation. Arch GynecolObstet 2010; 282(1):75-82.
[7] Emilee G, Ussher JM, Perz J. Sexuality after breast cancer: a review. Maturitas 2010; 66(4):397-407.
[8] American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4thed. Washington, DC: American Psychiatric Association; 1994.
[9] Hamiton M. Development of a rating scale for primary depressive illness. Br J SocClinPsychol 1967; 6(4):278-96
[10] Kirkpatrick LA, Feeney BC. A simple guide to IBM SPSS statistics for version 20.0. Student ed. Belmont, Calif.: Wadsworth, Cengage Learning; 2013.
[11] Huang XE, Li CG, Li Y, Lu YY, Tang JH, Xiang J. Weekly TP regimen as a postoperative adjuvant chemotherapy for completely resected breast cancer in China: final result of a phase II trial. Asian Pac J Cancer Prev 2011; 12(10):2797-800.
[12] Lagendijk M, van Egdom L, van Veen F, Vos E, Mureau M, van Leeuwen N, et al. Patient-reported outcome measures may add value in breast cancer surgery. Annals of surgical oncology. 2018;25(12):3563-71
[13] Berhili S, Ouabdelmoumen A, Sbai A, Kebdani T, Benjaafar N, Mezouar L. Radical Mastectomy Increases Psychological Distress in Young Breast Cancer Patients: Results of A Cross-sectional Study. Clinical breast cancer. 2019;19(1): e160-e5
[14] Jagsi R, Li Y, Morrow M, Janz N, Alderman A, Graff J, et al. Patient-reported Quality of Life and Satisfaction with CosmeticOutcomes After Breast Conservation and Mastectomy with and WithoutReconstruction: Results of a Survey of Breast Cancer Survivors. Ann Surg 2015; 261(6):1198-206.
[15] Tsai H-Y, Kuo RN-C, Chung K-p. Quality of life of breast cancer survivors following breast-conserving therapy versus mastectomy: a multicenter study in Taiwan. Japanese Journal of Clinical Oncology. 2017;47(10):909-18.

[16] Sun MQ, Meng AF, Huang XE, Wang MX. Comparison of psychological influence on breast cancer patients between breast-conserving surgery and modified radicalmastectomy. Asian Pac J Cancer Prev 2013; 14(1):149-52.
[17] Akyolcu N. Sexual life after surgery in breast cancer. J Breast Health 2008; 4:77-83.
[18] Cortés-Flores AO, Vargas-Meza A, Morgan-Villela G, Jiménez-Tornero J, Del Valle CJZ-F, Solano-Genesta M, Miranda-Ackerman RC, Vázquez-Reyna I, García-González LA, Cervantes-Cardona GA. Sexuality among women treated for breast Cancer: a survey of three surgical procedures. Aesthetic plastic surgery. 2017;41(6):1275-9.
[19] Rosenberg SM, Dominici LS, Gelber S, Poorvu PD, Ruddy KJ, Wong JS, Tamimi RM, Schapira L, Come S, Peppercorn JM. Association of Breast Cancer Surgery with Quality of Life and Psychosocial Well-being in Young Breast Cancer Survivors. JAMA surgery. 2020;155(11):1035-42.
[20] Akca M. The effects of treatment on psychosocial and sexual life as well as on quality of life in patients with breast cancer who underwent to surgical therapy. University Faculty of Medicine, Department of Internal Medical Sciences. Expertise thesis; 2011.
[21] Kement M, Gezen C, Aşik A, Karaöz A, Ustaalioğlu BÖ, Bilici A, et al. Breast conserving surgery and modified radical mastectomy in Turkish women with breast cancer: a prospective analysis of quality of life. TurkiyeKlinikleri J Med Sci2011; 31(6):1377-48‏.
[22] Acil H, Cavdar I. Comparison of quality of life of Turkish breast cancer patients receiving breast conserving surgery or modified radical mastectomy. Asian Pac J Cancer Prev 2014;15(13):5377-81.
[23] Trinh L, Amireault S, Lacombe J, Sabiston CM. Physical and psychological health among breast cancer survivors: interactions with sedentary behavior and physical activity. Psychooncology 2015; 24(10):1279-1285.
[24] Ng ET, Ang RZ, Tran BX, Ho CS, Zhang Z, Tan W, Bai Y, Zhang M, Tam WW, Ho RC. Comparing Quality of Life in Breast Cancer Patients Who Underwent Mastectomy Versus Breast-Conserving Surgery: A Meta-Analysis. International journal of environmental research and public health. 2019;16(24):4970.
[25] Hadi N, Soltanipour S, Talei A. Impact of modified radical mastectomy on health-related quality of life in women with early stage breast cancer. Arch Iran Med 2012; 15:504-7.
[26] He ZY, Tong Q, Wu SG, Li FY, Lin HX, Guan XX. A comparison of quality of life and satisfaction of women with early-stage breast cancer treated with breast conserving therapy v.s. mastectomy. İn Southern China.Support Care Cancer 2012; 20(10):2441-9.
[27] Akça M, Ata A, Nayır E, Erdoğdu S, Arıcan A. Impact of Surgery Type on Quality of Life in Breast Cancer Patients. J Breast Health 2014; 10(4):222-8.
[28] Qiu H, Xu W-H, Kong J, Ding X-J, Chen D-F. Effect of breast-conserving surgery and modified radical mastectomy on operation index, symptom checklist-90 score and prognosis in patients with early breast cancer. Medicine. 2020;99(11):e19279.
[29] Steinberg MD, Juliano MA, Wise L. Psychological outcome of lumpectomy versus mastectomy in the treatment of breast cancer. Am J Psychiat 2005; 42:34-39
[30] Zhang C, Hu G, Biskup E, Qiu X, Zhang H, Zhang H. Depression induced by total mastectomy, breast conserving surgery and breast reconstruction: A systematic review and meta-analysis. World journal of surgery. 2018;42(7):2076-85
[31] Sanger CK, Reznikoff M. A comparison of the psychosocial effects of breast-saving procedures with the modified radical mastectomy. Cancer 2011; 48:2341-6.
[32] Renneker R, Cutler M. Psychological problems of adjustment to cancer of the breast. J Am Med Ass 2002; 148:833-8.
[33] Alagaratnam TT, Kung NYT. Psychosocial effects of mastectomy: Is it due to mastectomy or to the diagnosis of malignancy. Br J Psychiat 2006; 149:296-9.
How to Cite
A. Abdelatif, G. Abounaggah, M. Elmesery, M. Asal, and M. Eweda, “THE PSYCHOLOGICAL IMPACT OF BREAST-CONSERVING SURGERY VERSUS MASTECTOMY IN EGYPTIAN FEMALE PATIENTS”, JSS, vol. 7, no. 4, pp. 124-133, Feb. 2021.