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

Authors

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

Published in

Annals of surgical oncology. Jul 17, 2026. Epub Jul 17, 2026.

Abstract

Women 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.
We 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.
In 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).
Decision 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.

PMID:
42467156
Bibliographic data and abstract were imported from PubMed on 17 Jul 2026.

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