Objectives-To assess outside a clinical trial the psychological outcome of different treatment policies in women with early breast cancer who underwent either mastectomy or breast conservation surgery depending on the surgeon's opinion or the patient's choice. To
Oncologists are hampered by inadequate communication skills training and will give up time to correct this. Subjective improvements reported immediately postcourse were maintained at 3 months. Resources for educational initiatives are needed to help both patients and their physicians.
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
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