Annals of Surgical Oncology

, Volume 23, Issue 10, pp 3133–3137 | Cite as

Breast Conservation Therapy Versus Mastectomy: Shared Decision-Making Strategies and Overcoming Decisional Conflicts in Your Patients

  • Julie A. Margenthaler
  • David W. Ollila
Breast Oncology


Although breast-conserving therapy is considered the preferred treatment for the majority of women with early-stage breast cancer, mastectomy rates in this group remain high. The patient, physician, and systems factors contributing to a decision for mastectomy are complicated. Understanding the individual patient’s values and goals when making this decision is paramount to providing a shared decision-making process that will yield the desired outcome. The cornerstones of this discussion include education of the patient, access to decision-aid tools, and time to make an informed decision. However, it is also paramount for the physician to understand that a significant majority of women with an informed and complete understanding of their surgical choices will still prefer mastectomy. The rates of breast conservation versus mastectomy should not be considered a quality measure alone. Rather, the extent by which patients are informed, involved in decision-making, and undergoing treatments that reflect their goals is the true test of quality. Here we explore some of the factors that impact the patient preference for breast conservation versus mastectomy and how shared decision-making can be maximized for patient satisfaction.


National Surgical Quality Improvement Program Decisional Conflict Ipsilateral Breast Tumor Recurrence Breast Surgeon Bilateral Mastectomy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Society of Surgical Oncology 2016

Authors and Affiliations

  1. 1.Department of SurgeryWashington University School of MedicineSt. LouisUSA
  2. 2.Department of SurgeryUniversity of North CarolinaChapel HillUSA

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