title: Patients' decision-making in a UK specialist centre with high mastectomy rates.
abstract: A national audit identified one breast cancer unit as having the highest mastectomy rate in the UK: 50% compared to a national average of 14% for cancers <15mm in diameter. This anomaly needed investigation. A questionnaire was sent within 2 years of their surgery to 189 breast cancer patients probing perceived surgical choice, factors in decision-making and usefulness of information. One hundred thirty-one (69%) replied, of these 97 (74%) felt they had choice of surgery. Of these, the most important factor was minimising worry about recurrence. However, only 16% knew that recurrence rates were different between types of surgery. Sixty-one percent felt their healthcare professionals had surgical preferences for them, believed that clinical issues determined these preferences, but still knew the choice was theirs. The extent to which surgical choice is offered and patients are made aware that it is their choice, may account for the high mastectomy rate in this unit.
authors.affiliation: Cancer Research UK Psychosocial Oncology Group, Brighton and Sussex Medical School, University of Sussex, Falmer, Brighton BN1 9QG, UK. R.S.Ballinger@sussex.ac.uk
authors.forename: Rachel S
authors.initials: RS
authors.lastname: Ballinger
authors.forename: Karl Fortes
authors.initials: KF
authors.lastname: Mayer
authors.forename: Gill
authors.initials: G
authors.lastname: Lawrence
authors.forename: Lesley
authors.initials: L
authors.lastname: Fallowfield
mesh_terms: D001291:Attitude of Health Personnel; D001943:Breast Neoplasms / Q000523:psychology / Q000601:surgery*; D003657:Decision Making; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008408:Mastectomy / Q000523:psychology / Q000706:statistics & numerical data*; D008875:Middle Aged; D010353:Patient Education as Topic / Q000706:statistics & numerical data; D010358:Patient Participation / Q000523:psychology / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D006113:United Kingdom