Abstract:
Background Despite robust evidence confrming equivalent survival rates and better cosmetic outcomes
with breast-conserving surgery (BCS) and radiotherapy compared to mastectomy, the rates of mastectomy
among women with early breast cancer have not declined signifcantly in Sri Lanka. This study explores views
on the surgical treatment of breast cancer among Northern Sri Lankan women who were eligible for BCS but under-
went mastectomy.
Methods An exploratory descriptive qualitative study was carried out among 15 women who underwent mastec-
tomy for early breast cancer. Patients who were referred to the Tellippalai Trail Cancer Hospital for adjuvant therapy
after mastectomy and matched the study criteria were recruited. Data were collected through in-depth semi-
structured interviews, which were transcribed in Tamil, translated into English, coded using QDA Miner Lite software,
and analysed thematically.
Results Nine out of 15 participants were either not aware of breast-conserving surgery (BCS) as a treatment option
or their eligibility for BCS at the time of mastectomy. According to participant narratives, the treating team had
recommended mastectomy to most participants. While many opted for mastectomy believing that it was associated
with lower rates of recurrence and spread compared to BCS, these beliefs were frequently reinforced by the treating
team. The pros and cons of the two approaches had not been discussed before surgery with most participants. In
the absence of information, family and friends weighed in on the decision to opt for mastectomy, ultimately resulting
in feelings of loss and regret in most instances.
Conclusion Most participants were not aware that they were eligible for BCS. These information gaps need to be
urgently addressed for women to make informed decisions about their health.
