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Keywords:

  • breast cancer;
  • modified radical mastectomy;
  • breast conserving treatment;
  • decision-making;
  • choice of surgery;
  • conflict theory of decision-making

Factors influencing women’s decisions for choice of surgery for Stage I and Stage II breast cancer in Western Australia

Background. Internal and external factors have been reported to influence decision-making by women for breast cancer surgery.

Aim of the study. The aim of the study was to describe the factors those women with Stage I or Stage II breast cancer, perceived to be important when selecting either modified radical mastectomy or breast conserving treatment.

Design/method. A descriptive correlational study was conducted. A consecutive sample of women with a diagnosis of breast cancer during a 6-month period was selected from the Health Department of Western Australia Cancer Registry.

Results. Women who had breast conserving treatment rated the surgeon’s preference as a more important factor in decision-making than women who had modified radical mastectomy. The lack of difference in long-term survival between the types of surgery was also a more important influence on decision-making for the breast conserving treatment group compared with women who had received modified radical mastectomy. Women in rural areas tended to choose modified radical mastectomy rather than breast conserving treatment. The surgeon, family and general practitioner were important sources of information. A significant association was found between women’s involvement in decision-making and their use of a general practitioner as an information source. Many women wanted the decision about surgery to be entirely their own; the breast conserving treatment group preferred a more active role in decision-making compared with those who chose modified radical mastectomy. Most women had participated in the decision-making process as much as they wished, had enough time in which to make their decisions and had received sufficient information. A correlation between adequacy of information and sufficient time for decision-making was found.

Conclusion. Findings may be useful to nurses and other health professionals who endeavour to provide adequate information and support to women during their initial treatment decision-making experience.