Abstract
Background: Many sources have suggested that mastectomy is inappropriately performed too frequently for breast cancer, leading to excessive patient dissatisfaction and unnecessary multilation. Hurried decision-making based on inadequate information has been proposed as an explanation.
Methods: After confirming the diagnosis of breast cancer, patients were informed of the diagnosis, prognosis, and treatment options according to a standard protocol. The protocol was similar to that used by many surgeons in similar circumstances. Six months after completion of either mastectomy or breast conservation therapy, patients were surveyed about their satisfaction with the decision-making process and choice of treatment.
Results: The majority of patients, whether they had undergone mastectomy or breast conservation, thought they had been adequately informed of treatment options and that they had made the appropriate choice of therapy. A significant percentage of mastectomy patients found that procedure more disfiguring than anticipated, but still thought they had made the appropriate choice of therapy. Despite having been informed to the contrary, most patients said their chosen treatment provided the best chance for cure.
Conclusions: When informed of the diagnosis and treatment options in an unhurried, supportive setting, and when encouraged to seek further consultations as desired, breast cancer patients make appropriate therapeutic choices about mastectomy or breast conservation therapy.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Treatment of early-stage breast cancer. NIH Consensus Conference.JAMA 1991;265:391–5.
Steele GD Jr., Osteen RT, Winchester DP, Murphy GP, Menck HR. Clinical highlights from the National Cancer Data Base: 1994.CA Cancer J Clin 1994;44:71–80.
Winchester DP, Steele GD, Mench HR, et al.National Cancer Data Base: annual review of patient care, 1993. Atlanta: American Cancer Society, 1993:14.
Kolata G. Why do so many women have breasts removed needlessly?The New York Times Health, May 5, 1993.
Fisher B. Justification for lumpectomy in the treatment of breast cancer: a commentary on the underutilization of that procedure.J Am Med Women's Assoc 1992;47(September/October):169–73.
Grandi S, Fava GA, Cunsolo A, Saviotti FM, et al. Rating depression and anxiety after mastectomy: observer versus self-rating scales.Int J Psychiatry Med 1990;20:163–71.
Margolis G, Goodman R. The question of psychological benefit from breast-conserving treatment vs mastectomy.Oncology 1990;4:4–16.
Omne-Ponten M, Holmberg L, Burns T, Adami HO, et al. Determinants of the psycho-social outcome after operation for breast cancer: results of a prospective comparative interview study following mastectomy and breast conservation.Eur J Cancer 1992;28A:1062–7.
Levy SM, Haynes LT, Herberman RB, Lee J, et al. Mastectomy versus breast conservation surgery: mental health effects at long-term follow-up.Health Psychol 1992;11:349–54.
Ganz PA, Coscarelli Schag CA, Lee JJ, Polinsky ML, et al. Breast conservation versus mastectomy: is there a difference in psychological adjustment or quality of life in the year after surgery?Cancer 1992;69:1729–38.
Schain WS, d'Angelo TM, Dunn ME, Lichter AS, et al. Mastectomy versus conservative surgery and radiation therapy: psychosocial consequences.Cancer 1994;73:1221–8.
Fallowfield LJ, Hall A. Psychosocial and sexual impact of diagnosis and treatment of breast cancer.Med Bull 1991;47:388–99.
Wolberg WH. Mastectomy or breast conservation in the management of primary breast cancer: psychosocial factors.Oncology 1990;4:101–6.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Weiss, S.M., Wengert, P.A., Martinez, E.M. et al. Patient satisfaction with decision-making for breast cancer therapy. Annals of Surgical Oncology 3, 285–289 (1996). https://doi.org/10.1007/BF02306284
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02306284