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Psychological effects of being offered choice of surgery for breast cancer

Cancer Research Campaign Communication and Counselling Research Centre, Department of Oncology, University College London Medical School, London W1P 7PL Cancer Research Campaign Psychological Medicine Group, Christie Hospital, Manchester M20 9BX Royal Marsden, Hospital, London SW3 6JJ Correspondence to: Dr L J Fallowfield, Cancer Research Campaign Communication and Counselling Research Centre, Department of Oncology, University College London Medical School, 3rd Floor, Bland Sutton Institute, 48 Riding House Street, London WIP 7PL.

The putative benefits of patients participating in decision making in health care are frequently asserted by the proponents of a strong consumerist approach but are supported by few data. The proponents argue, for example, that an opportunity to choose surgery prevents the psychological morbidity associated with breast cancer. Results from studies are equivocal, although the studies are often based on small samples with short follow up and minimal assessment of morbidity.*RF 1-3* We report psychological data from a prospective study covering three years which compared women treated by surgeons who offered choice whenever possible with women treated by surgeons who favoured either mastectomy or breast conserving surgery.

Patients, methods, and results

We studied 269 consecutive patients aged under 75 with stage I or II breast cancer in south east England. We assessed them using semistructured psychiatric interviews and standardised questionnaires before treatment and at two . . . [Full text of this article]

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