Related Experiment Video
Updated: Jul 1, 2026
Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
Patients' decision-making in a UK specialist centre with high mastectomy rates
Rachel S Ballinger1, Karl Fortes Mayer, Gill Lawrence
1Cancer Research UK Psychosocial Oncology Group, Brighton and Sussex Medical School, University of Sussex, Falmer, Brighton BN1 9QG, UK. R.S.Ballinger@sussex.ac.uk
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.
