title: Variables affecting patient satisfaction in breast surgery: a cross-sectional sample of Turkish women with breast cancer.
abstract: OBJECTIVE
  In Turkey, despite the fact that breast cancer accounts for 24.1% of all cancer in women, a very small number of these patients receive breast reconstruction. This low percentage would seem to indicate that there are several factors affecting the decision of which surgical procedure should be selected. The aim of this study was to establish the demographical, medical, and psychological factors associated with the breast cancer patient's decision-making process, and assess their satisfaction with the type of surgery received.
  
  
  METHODS
  We assessed long-term satisfaction with the type of surgery received; satisfaction with the information process by which the surgery decision is taken; feelings of ambivalence or regret regarding the type of surgery received in both mastectomy (n = 50) and breast reconstruction patients (n = 25). Additionally, breast cancer survivors were compared with age-matched healthy control volunteers (n = 50) in terms of demographics, body image and self-esteem, which could be expected to affect their preferences. We administered a demographical and medical information form, Structured Clinical Interview for DSM-IV, Clinical Version (SCID-I), the Body Cathexis Scale (BCS); and the Rosenberg Self-Esteem Scale (RSE).
  
  
  RESULTS
  In both groups, women with a low income and less education were more likely to experience decision regret or low satisfaction. Moreover, total mastectomy-alone patients had lower self-esteem compared to reconstructive surgery patients and healthy women.
  
  
  CONCLUSIONS
  Early stage breast cancer is a chronic disease and patients have to live with the consequences of their decision for many years. At the same time, the type of surgery is decided on when patients are in an acute phase and under intense pressure. Therefore, the decision making process needs to be explored more, especially breast cancer patients with less education and low income need better assistance and more detailed explanation of their options.
authors.affiliation: Ege University School of Medicine, Izmir, Turkey. aysin.noyan@ege.edu.tr
authors.forename: M Aysin
authors.initials: MA
authors.lastname: Noyan
authors.forename: Ozen Onen
authors.initials: OO
authors.lastname: Sertoz
authors.forename: Hayriye
authors.initials: H
authors.lastname: Elbi
authors.forename: Ragip
authors.initials: R
authors.lastname: Kayar
authors.forename: Rasih
authors.initials: R
authors.lastname: Yilmaz
mesh_terms: D000328:Adult; D001828:Body Image; D001943:Breast Neoplasms / Q000523:psychology* / Q000601:surgery; D003430:Cross-Sectional Studies; D003657:Decision Making; D004522:Educational Status; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000523:psychology*; D015413:Mastectomy, Simple / Q000523:psychology*; D017060:Patient Satisfaction; D011203:Poverty; D012649:Self Concept; D014421:Turkey