Factors Influencing Patients' Decisions for Choice of Mastectomy or Breast-conserving Surgery

Abstract

Abstract

The purpose of this study was to identify the factors influencing patients' decisions for choice of surgery for women with early breast cancer, and to suggest nursing interventions to support the patients' decision-making. The participants of the study were 18 women who were offered a choice between breast-conserving surgery and mastectomy. The data were collected using a semi-structured interview and participant observation, so as to clarify the feelings and ideas of these subjects concerning the treatment options offered. We used qualitative data analyses.

As a result, out of 19 factors, “high possibility of breast-conserving surgery”, “results of breast cancer treatment”, and “feeling of their dear breast” were recognized as main factors to incline toward breast-conserving surgery, while “risk of the breast-conserving surgery”, “uncertainties of cancer”, and “impact of those around one during hospitalization” were found as main factors for mastectomy. These factors were classified into seven categories of : 1) uncertainties of cancer, 2) trend and results in treatment of breast cancer, 3) criterion of breast-conserving surgery, 4) benefits and risks of mastectomy or breast-conserving surgery, 5) , impact of people's experience and suggestions 6) ambiguous information, and 7) patient's personal background.

The findings indicated that the following nursing interventions might facilitate the decision-making process, as follows : provision of gradual and correct information to assist patient's understandings, supporting the impact of the risk of each option and breast loss, and supporting to make patients clear on values of the breast and views of life.