Factors influencing options in primary XXXX treatment.

@entity5 @entity1 @entity0
Primary @entity0 treatment is determined by @entity5 factors and by @entity1 preference. @entity0 treatments that preserve the cosmetic appearance of the breast are appealing and effective for appropriately selected @entity1 ; long-term survival following @entity5 excision and breast irradiation appears to be comparable to that for mastectomy. Since April 1981, when a protocol was developed and treatment options were offered, factors influencing treatment selection have been analyzed in 206 consecutive primary @entity0 @entity1 . Mastectomy was dictated by @entity5 -related factors in 96 @entity1 (47%); 110 @entity1 (53%) had the option of mastectomy or conservation-- @entity5 excision plus radiotherapy to the breast. Among these 110 eligible @entity1 , 54 chose conservation (49%) and 56 chose mastectomy (51%). Intraoperative findings for ten @entity1 electing conservation necessitated mastectomy, so conservation was accomplished for 44 (21%) of those treated for @entity0 . Beginning in July 1982, @entity0 @entity1 took a battery of psychosexual assessments before any operation (Profile of Mood States [POMS], Health Locus of Control Scale [HLCS] Locke-Wallace Marital Adjustment Test [MAT], Psychosocial Adjustment to Illness Scale [PAIS], Derogatis Sexual Function Inventory [DSFI], Millon Clinical Multiaxial Inventory [MCMI], and a @entity0 Information Test [BCIT]). Comparisons of psychologic and demographic variables were made between @entity1 who chose mastectomy and those who chose conservation. No demographic variable was statistically significantly related to choice, although older @entity1 tended to select mastectomy more than younger @entity1 . Compared with those who elected conservation, @entity1 who elected mastectomy were more tense and anxious (P less than .01), more introverted (P less than .01), felt more depressed and dejected (P less than .05), and reported more sexual problems (P less than .05). Those who elected conservation valued their physical appearance more highly (P less than .01) and were generally more self-interested (P less than .05). Mastectomy was dictated by medical considerations for approximately half of @entity1 with @entity0 . Among candidates for breast conservation, the importance of retaining the breast appeared to be determined to a significant degree by measurable psychological factors.
