Evidence map›Paper›PMID 42467156›Full record

ArticleAnnals of surgical oncology2026

Association Between Decision Regret and Psychosocial Outcomes Following Surgery Among Women with Unilateral Nonhereditary Breast Cancer.

Aghaghia Mokhber, Katelynn Tang, Oladele Situ, Anne C O'Neill, Tulin D Cil, Toni Zhong, Stefan O P Hofer, David R McCready, Kelly Metcalfe, David W Lim

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Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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10 authors.

Aghaghia MokhberWomen's College Research and Innovation Institute, Women's College Hospital, Toronto, ON, Canada.
Katelynn TangDivision of General Surgery, Department of Surgery, North York General Hospital, Toronto, ON, Canada.
Oladele SituDivision of General Surgery, Department of Surgery, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Anne C O'NeillDivision of Plastic Surgery, Sprott Department of Surgery, University Health Network, Toronto, ON, Canada.
Tulin D CilDivision of General Surgery, Department of Surgery, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Toni ZhongDivision of Plastic Surgery, Sprott Department of Surgery, University Health Network, Toronto, ON, Canada.
Stefan O P HoferDivision of Plastic Surgery, Sprott Department of Surgery, University Health Network, Toronto, ON, Canada.
David R McCreadyDivision of General Surgery, Department of Surgery, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Kelly MetcalfeWomen's College Research and Innovation Institute, Women's College Hospital, Toronto, ON, Canada.
David W LimWomen's College Research and Innovation Institute, Women's College Hospital, Toronto, ON, Canada. David.Lim@wchospital.ca.ORCID http://orcid.org/0000-0002-2397-4110

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWomen with unilateral breast cancer continue to choose (unilateral or bilateral) mastectomy. We aim to determine decision regret and its relationship with psychosocial outcomes after breast cancer surgery.

methodsWe performed a prospective cohort study of women with unilateral, sporadic stage 0-III breast cancer at University Health Network (Toronto, Canada) who underwent unilateral lumpectomy (UL), unilateral mastectomy (UM), or bilateral mastectomy (BM). Unilateral mastectomy was further categorized into oncologically indicated (UMO) versus patient choice (UMC). Participants completed the Decision Regret Scale (DRS), BREAST-Q, Impact of Event Scale, and Hospital Anxiety and Depression Scale at 12 or 18 months after surgery. Univariable and multivariable linear regression models were adjusted for demographic, clinical, and treatment-related factors. P < 0.05 was deemed significant.

resultsIn total, 217 women were included, including 51 UL, 95 UM (71 UMO, 24 UMC), and 71 BM. There was a difference in DRS scores between UL and UM (8.3 vs. 17.4; P <0.01). Bilateral mastectomy was not associated with higher regret. After adjustment for covariates, UMC remained significantly associated with greater decision regret (β = 16.0, SE = 7.6, P = 0.04). Among women having UMC, women with higher regret had lower scores of breast satisfaction (β = -1.0, SE = 0.5, P = 0.03) and psychosocial well-being (β = -0.8, SE = 0.4, P = 0.02).

conclusionsDecision regret is influenced by surgical procedure in women with unilateral breast cancer. Women who have unilateral mastectomy, particularly those who choose the procedure when eligible for lumpectomy, report higher decision regret and worse breast satisfaction and psychosocial well-being.

Indexed as

Breast NeoplasmsDecision MakingEmotionsMastectomyMastectomy, SegmentalQuality of LifeUnilateral Breast NeoplasmsAgedAnxietyDepressionFemaleFollow-Up StudiesHumansMiddle AgedPrognosisProspective StudiesAnxietyBREAST-QDecision regretDepressionDistressLumpectomyMastectomyPsychosocial

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PMID42467156

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