Supportive Care in Cancer

, Volume 15, Issue 7, pp 841–847

Ways to obtain a breast cancer diagnosis, consistency of information, patient satisfaction, and the presence of relatives

  • Henning Brake
  • Heike Saßmann
  • Dorothee Noeres
  • Mechthild Neises
  • Siegfried Geyer
Original Article


Goals of work

What physicians told breast cancer patients about their diagnosis, who informed them, and how this information was conveyed were examined in this study. Finally, the relatives’ role in this communication process was considered.

Materials and methods

Women with primary breast cancer (N = 222) below the age of 70 were interviewed after surgery and after they were informed about their diagnosis.

Main results

One hundred twenty-one women consulted their primary gynecologist first, then they were referred to a radiologist, and finally to the secondary care gynecologist. Forty-seven women omitted the radiologist and only five went directly to the hospital for treatment. In most cases (N = 199), the general practitioner was not involved. Receiving inconsistent information was associated with patient dissatisfaction. This also applies to women who received their diagnosis on the phone. Women awaiting a worse diagnosis were more likely to be accompanied by another person.


Future studies should focus on the possible involvement of family doctors and relatives during the diagnostic process. Giving inconsistent information should be avoided.


Cancer diagnosis Information Consistency Health care utilization Relatives Patient’s satisfaction 


  1. 1.
    Angelica MD, Hirsch K, Ross H, Passik S, Brennan MF (1998) Surgeon–patient communication in the treatment of pancreatic cancer. Arch Surg 133:962–966PubMedCrossRefGoogle Scholar
  2. 2.
    Asai A (1995) Should Physicians tell patients the truth. West J Med 163:36–39PubMedGoogle Scholar
  3. 3.
    Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (Association of the scientific medical societies in Germany) (2005)
  4. 4.
    Back AL (2002) Communicating bad news. West J Med 176:177–180PubMedCrossRefGoogle Scholar
  5. 5.
    Bennett M, Alison D (1996) Discussing the diagnosis and prognosis with cancer patients. Postgrad Med J 72:25–29PubMedCrossRefGoogle Scholar
  6. 6.
    Bertakis KD, Roter D, Putnam SM (1991) The relationship of physicians medical interview style to patient satisfaction. J Fam Pract 32:175–181PubMedGoogle Scholar
  7. 7.
    Beyene Y (1992) Medical disclosure and refugees—telling bad news to Ethiopian patients. West J Med 157:328–332PubMedGoogle Scholar
  8. 8.
    Blackhall LJ, Murphy ST, Frank G, Michel V, Azen S (1995) Ethnicity and attitudes toward patient autonomy. JAMA 274:820–825PubMedCrossRefGoogle Scholar
  9. 9.
    Brozcuk H, Erdogan V, Eken C, Ciplak E, Samur M, Özdogan M, Savas B (2002) Does awareness of diagnosis make any difference to quality of life? Determinants of emotional functioning in a group of cancer patients in Turkey. Support Care Cancer 10:51–57CrossRefGoogle Scholar
  10. 10.
    Buckman R (1996) Talking to patients about cancer—no excuse now for not doing it. BMJ 313 (Editorial)Google Scholar
  11. 11.
    Butow PN, Kazemi JN, Beeney LJ, Griffin AM, Dunn SM, Tattersall MH (1996) When the diagnosis is cancer: patient communication experiences and preferences. Cancer 77:2630–2637PubMedCrossRefGoogle Scholar
  12. 12.
    Cassileth BR, Zupkis RV, Sutton-Smith K, March V (1980) Information and participation preferences among cancer patients. Ann Intern Med 92:832–836PubMedGoogle Scholar
  13. 13.
    Da Silva CH, Cunha RL, Tonaco RB, Cunha TM, Diniz AC, Domingos GG, Silva JD, Santos MV, Antoun MG, de Paula RL (2003) Not telling the truth in the patient–physician relationship. Bioethics 17:417–424PubMedCrossRefGoogle Scholar
  14. 14.
    Dragset S, Lindstrom TC (2005) Coping with a possible breast cancer diagnosis: demographic factors and social support. J Adv Nurs 51: 217–226CrossRefGoogle Scholar
  15. 15.
    Estape J, Palombo H, Hernandez E, Daniels M, Estape T, Grau JJ, Vinolas N, Mane JM (1992) Cancer diagnosis disclosure in a Spanish hospital. Ann Oncol 3:451–454PubMedGoogle Scholar
  16. 16.
    European Observatory on Health Care Systems (2000) health Care systems in transition. WHO Regional Office for Europe, CopenhagenGoogle Scholar
  17. 17.
    Fallowfield LJ (1992) The ideal consultation. Br J Hosp Med 47:364–367PubMedGoogle Scholar
  18. 18.
    Fallowfield LJ (1995) Can we improve the professional and personal fulfilment of doctors in cancer medicine? Br J Cancer 71:1132–1133PubMedGoogle Scholar
  19. 19.
    Fallowfield L, Jenkins V (1999) Effective communication skills are the key to good cancer care. Eur J Cancer 35:1592–1597PubMedCrossRefGoogle Scholar
  20. 20.
    Frostholm L, Fink P, Oernboel E, Christensen KS, Toft T, Olesen F, Weinman J (2005) The uncertain consultation and patient satisfaction: the impact of patients’ illness perceptions and a randomized controlled trial on the training of physicians’ communication skills. Psychosom Med 67:897–905PubMedCrossRefGoogle Scholar
  21. 21.
    Gask L, Usherwood T (2002) ABC of psychological medicine: the consultation. BMJ 324:1567–1569PubMedCrossRefGoogle Scholar
  22. 22.
    Gattellari M, Voigt KJ, Butow PN, Tattersall MHN (2002) When the treatment goal is not cure: are cancer patients equipped to make informed decisions? J Clin Oncol 20:503–513PubMedCrossRefGoogle Scholar
  23. 23.
    Grassi L, Giraldi T, Messina EG, Magnani K, Valle E, Cartei G (2000) Physicians attitudes to and problems with truth-telling to cancer patients. Support Care Cancer 8:40–45PubMedGoogle Scholar
  24. 24.
    Holland JC, Geary N, Marchini A, Tross S (1987) An international survey of physician attitudes and practice in regard to revealing the diagnosis of cancer. Cancer Invest 5:151–154PubMedGoogle Scholar
  25. 25.
    Kaufmann M, Ernst B (2000) Was Frauen mit Krebs erfahren, empfinden, wissen und vermissen. Deutsches Ärzteblatt 97:3191–3196Google Scholar
  26. 26.
    Liang W, Burnett CB, Rowland JH, Meropol NJ, Eggert L, Hwang YT, Silliman RA, Weeks JC, Mandelblatt JS (2002) Communication between physicians and older women with localized breast cancer: implications for treatment and patient satisfaction. J Clin Oncol 20:1008–1016PubMedCrossRefGoogle Scholar
  27. 27.
    Lind SE, Del Vecchio Good MJ, Seidel S, Csordas T, Good BJ (1989) Telling the diagnosis of cancer. J Clin Oncol 7:583–589PubMedGoogle Scholar
  28. 28.
    Maguire P, Pitceathly C (2002) Key communication skills and how to acquire them. BMJ 325:697–700PubMedCrossRefGoogle Scholar
  29. 29.
    Makoul G (2001) Essential elements of communication in medical encounters: the Kalamazoo consensus statement. Acad Med 76:390–393PubMedCrossRefGoogle Scholar
  30. 30.
    Miyata H, Tachimori H, Takahashi M, Saito T, Kai I (2004) Disclosure of cancer diagnosis and prognosis: a survey of the general public’s attitudes toward doctors and family holding discretionary powers. BMC Med Ethics 5:E7PubMedCrossRefGoogle Scholar
  31. 31.
    Mystakidou K, Parpa E, Tsilika E, Kalaidopoulou O, Vlahos L (2002) The families evaluation on management, care and disclosure for terminal stage cancer patients. BMC Palliat Care 1(1):3PubMedCrossRefGoogle Scholar
  32. 32.
    Mystakidou K, Parpa E, Tsilika E, Katsouda E, Vlahos L (2003) Cancer information disclosure in different culture contexts. Support Care Cancer 12:147–154CrossRefGoogle Scholar
  33. 33.
    Noone I, Crowe M, Pillay I, O’Keeffe ST (2000) Telling the truth about cancer: views of elderly patients and their relatives. Ir Med J 93:104–105PubMedGoogle Scholar
  34. 34.
    Novack DH, Plumer R, Smith RL, Ochitill H, Morrow GR, Benett JM (1979) Changes in physicians’ attitudes toward telling the cancer patient. JAMA 241:897–900PubMedCrossRefGoogle Scholar
  35. 35.
    Oelz O (1996) Truth-telling in medical dialogue: compassionate lie or merciless statistics? Schweiz Rundsch Med Prax 85:440–444PubMedGoogle Scholar
  36. 36.
    Sullivan RJ, Menapace LW, White RM (2001) Truth telling and patient diagnosis. J Med Ethics 27:192–194PubMedCrossRefGoogle Scholar
  37. 37.
    Surbone A (2004) Persisting differences in truth telling throughout the world. Support Care Cancer 12:143–146PubMedCrossRefGoogle Scholar
  38. 38.
    Tang ST, Lee SY (2004) Cancer diagnosis and prognosis in Taiwan: patient preferences versus experiences. Psychooncology 13:1–13PubMedGoogle Scholar
  39. 39.
    Thomsen OO, Wulff HR, Martin A, Singer PA (1993) What do gastroenterologists in Europe tell cancer patients? Lancet 341:473–476PubMedCrossRefGoogle Scholar
  40. 40.
    Vass A (2003) Health literacy and patients’ understanding. BMJ 326:1339CrossRefGoogle Scholar
  41. 41.
    Veronesi U, Von Kleist S, Redmond K, Costa A, Delvaux N, Freilich G, Glaus A, Hudson T, McVie JG, Macnamara C, Meunier F, Pecorelli S, Serin D; the CAWAC Study Group (1999) Caring about women and cancer (CAWAC): a European survey of the perspectives and experiences of women with female cancers. Eur J Cancer 35:1667–1675PubMedCrossRefGoogle Scholar
  42. 42.
    Wright EB, Holcombe C, Salmon P (2004) Doctors communication of trust, care and respect in breast cancer: qualitative study. BMJ 328:364CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Henning Brake
    • 1
  • Heike Saßmann
    • 2
  • Dorothee Noeres
    • 1
  • Mechthild Neises
    • 3
  • Siegfried Geyer
    • 1
  1. 1.Medical Sociology UnitHannover Medical SchoolHannoverGermany
  2. 2.Medical Psychology UnitHannover Medical SchoolHannoverGermany
  3. 3.Psychosomatic Gynaecology UnitHannover Medical SchoolHannoverGermany

Personalised recommendations