Lally found that many women already had a plan in mind when they entered the surgeon's office which they then weighed against the surgeon's input. Their surgical treatment decisions were motivated by the desire to: eliminate future inconvenience and worry about cancer balanced by avoiding mastectomy unless medically required; maintain physical function and appearance; and recover rapidly. Most women felt that mastectomy should be reserved only for the worst breast cancers. Older women saw advanced age as an advantage -- age protected them from worry of recurrence and/or the significant concern over loss of their breast although they still chose lumpectomy.

Women of all ages expressed surprise that their surgeons did not make a definitive recommendation, but that the choice of mastectomy or lumpectomy was ultimately their own. Even women who wanted to make their own decision still desired a recommendation from the surgeon. When making a choice, however, they drew confidence from the surgeons' support of their decision. Lally hopes that surgeons and nurses will be inspired by her findings to assess their breast cancer patients' expectations and understanding regarding their options and the decision-making process at the beginning of each consultation and be aware of the important role providers play in supporting women's ability to make this decision.

Breast cancer survivors can also benefit from this research. Lally hopes that, "survivors reading this study may find 'a little of themselves' in the women's narratives and feel comforted in the realization that others also had moments of feeling overwhelmed, uncertain or surprised by the surgical decision-making process -- you are not alone."

Lally currently has a grant under review in collaboration with Roswell Park Cancer Institute's Breast Center to study the thought processes of African-American women in response to their breast cancer diagnosis. She intends to use all of her research to develop assessment and intervention tools for health care professionals in order to identify women who may be at risk for ongoing distress beyond this early time period.

Source: University at Buffalo