2018, Number 2
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Cir Plast 2018; 28 (2)
Mastectomy versus lumpectomy in the treatment of breast cancer: Bioethical implications
Pérez GR, Garzón MJ, Baley SI, Villaseñor VE, Márquez EC
Language: Spanish
References: 19
Page: 92-96
PDF size: 241.13 Kb.
ABSTRACT
Scientific and biotechnological advances, as well as the emergence of social and legal factors in the world of health, have led, especially medicine to reconsider its study and practice. The current expectations of doctors, patients and their families exceed the classic objectives of medical care. Until a few years ago, the treatment of mammary carcinoma was the classic radical mastectomy, with or without post-operative radiotherapy. However, at present with lumpectomy, the therapeutic criterion have been modified, there is a greater knowledge of the natural history of the disease, there are drugs that are more effective and in current medicine, the importance of the quality of life that a patient has after the treatment is of utmost importance. There are documents that claim that a mastectomy causes undesirable effects in women. Mastectomy, unlike lumpectomy, is a more invasive surgical procedure. It is common to find depression, anxiety, insomnia, shame, insecurity, suicidal thoughts and feelings of worthlessness in the patient, significantly affecting their «quality of life». All factors and the possible consequences of the surgeon’s actions must be considered and efforts must be made not only to take into account the disease. It needs to be integrated in order to provide better results that translate into a better recovery and quality of life.
REFERENCES
Casas M. Bases bioéticas. México: Trillas; 2008.
Goic GA. Tendencias de la medicina actual. Rev Med Chile 1999; 127 (9): 1136-1138.
Beauchamp TL, Childress JF. Principles of biomedical ethics: oxford university press. 1979, p. 191.
Coleman MP, Quaresma M, Berrino F, Lutz JM, De Angelis R, Capocaccia R, Baili P, Rachet B, Gatta G, Hakulinen T, Micheli A, Sant M et al. Cancer survival in five continents: a worldwide population-based study (CONCORD). Lancet Oncol 2008; 9 (8): 730-756.
http://www.who.int/topics/cancer/breastcancer/es/
Hwang ES, Lichtensztajn DY, Gomez SL, Fowble B, Clarke CA. Survival after lumpectomy and mastectomy for early stage invasive breast cancer: the effect of age and hormone receptor status. Cancer 2013; 119 (7): 1402-1411.
National Institutes of Health Consensus Development Conference Statement: The treatment of Early Stage Breast cancer. Bethesda, MD: Author; 1990.
Wording JW, Weisman AD. The fallacy in post mastectomy depression. Am J Med Sci 1977; 273: 169-175.
Schipper H, Clinch J, Olweny C. Quality of life and pharmacoeconomics in clinical trials. Quality of life studies: definitions and conceptual issues. Lippincott: Philadelphia 2ª ed. 1996, pp. 25-35.
Patrick D, Erickson P. Health status and health policy; Quality of life in health care evaluation and resource allocation. Oxford University Press. New York, 1993.
Price B. A model for body-image care. J Adv Nurs 1990; 15: 585-593.
Rytina S. Imagined ugliness. Sci Am Mind 2008; 19: 72-77.
Hart S, Meyerowits BE, Apolone G, Masconi P, Liberati A. Quality of life among mastectomy patients using external breast prostheses. Tumori 1997; 83: 581-586.
Wellish DK, Dimatteo R, Silversteim M. Psychosocial outcomes of breast cancer therapies: lumpectomy versus mastectomy. Psychosomatics 1989; 30: 365-373.
Margolis GJ, Goodman RL, Rubin A, Pajac TF. Psychological factors in the choice of treatment breast cancer. Psychosomatics 1989; 30 (2): 192-197.
Levy SM, Herberman RB, Lee JK Lippman ME, D Angelo T. Breast conservation versus mastectomy: distress sequel as a function of choice. J Clin Oncol 1989; 7 (3): 367-375.
González F. Tratamiento quirúrgico del carcinoma mamario. Rev Inst Nac Cancer Méx 1986; 32 (3/4): 212-217.
http://www.bioeticahoy.com.es/2010/02/principio-de-doble-efecto.html
Guadagnoli E, Ward P. Patient participation in decision-making. Soc Sci Med 1998; 47 (3): 329-339.