Participation in decision making regarding type of surgery and treatment-related satisfaction in North Indian women with early breast cancer

Abstract

Introduction: Breast conserving surgery followed by radiotherapy is an established modality of treatment in early breast cancer patients since three decades, but yet it has not been adopted worldwide. Purpose: The aim of this study is to investigate the factors affecting decision making regarding type of surgery and satisfaction with type of surgery in North Indian women with early breast cancer. Materials and Methods: A questionnaire was prepared to assess the factors responsible for decision making regarding type of surgery (breast conserving surgery (BCS) versus modified radical mastectomy (MRM) and to evaluate involvement of patient in decision making regarding the type of surgery. 47 women with early breast cancer on radiotherapy or on follow-up were interviewed by the resident doctors. Results: Out of 47 patients, 28 underwent BCS and 19 MRM. Women undergoing BCS were younger, more literate than in those undergoing MRM. In the two arms (BCS versus MRM), decision for surgery was made by surgeon alone in 53% versus 73%, along with patient in 42% versus 6%, and only 10% women participated in decision making in each arm. Only 50% versus 30% patients had a clear understanding of the risks and benefits of both procedures in the two arms. Conclusion: North Indian women do not independently take decision regarding any type of surgery. The reason for opting for either kind of surgery was based on surgeon's recommendation or concern about recurrence. Body image was not an issue amongst majority.