LONG BEACH, Calif--A breast cancer patient who is a good candidate
for breast conservation says to her physician, "I want a
mastectomy. I don't want to have radiation."
By referring to a 1992 study that compared quality of life outcomes
among women who had mastectomy and those who chose breast conservation,
the physician can tell his patient with confidence that women
report little difference between the two treatments in their impact
on quality of life.
The only significant differences reported in this study were in
terms of body image and clothing fit, which were significantly
better among the lumpectomy patients.
Patricia Ganz, MD, used this example of a practical application
of a quality of life study in her presentation at the 1995 Quality
of Life symposium, sponsored by St. Mary Medical Center.
Dr. Ganz, of the Jonsson Comprehensive Cancer Center, Los Angeles,
also cited one of the first studies to look at quality of life
in addition to survival, published in 1987.
The main thrust of this randomized study of women with advanced
metastatic breast cancer, Dr. Ganz said, was to compare continuous
chemotherapy with intermittent therapy (3 months of treatment
with resumption of therapy only when symptoms recur).
The researchers hypothesized that the continuous chemotherapy
would have more adverse effects on quality of life, but in fact,
the study showed that quality of life was better in patients receiving
continuous therapy. They also found that baseline quality of life
predicted long-term survival.