Intended for healthcare professionals

Research Article

Psychological impact of adjuvant chemotherapy in the first two years after mastectomy.

Br Med J (Clin Res Ed) 1986; 293 doi: (Published 15 November 1986) Cite this as: Br Med J (Clin Res Ed) 1986;293:1268

This article has a correction. Please see:

  1. A V Hughson,
  2. A F Cooper,
  3. C S McArdle,
  4. D C Smith


    Psychological symptoms were assessed over two years in a randomised trial of three forms of treatment given to women after mastectomy for stage II breast cancer. The treatments were: three weeks' radiotherapy; one year's adjuvant chemotherapy with cyclophosphamide, methotrexate, and 5-fluorouracil; and radiotherapy followed by chemotherapy. Analysis of the results on an intention to treat basis showed no substantial differences in depression or anxiety among groups at one, three, or six months after the operation. At 13 months, however, patients who had been allocated chemotherapy had significantly more symptoms, especially depression, than control patients treated with radiotherapy alone. Conditioned reflex nausea and vomiting increased considerably during the second six months of chemotherapy and persisted for up to a year afterwards. The psychological morbidity of adjuvant chemotherapy could be substantially reduced if courses of treatment were restricted to about six months.