Doctor-patient communication as perceived by women with a mammary nodule recommended for biopsy

Abstract

Objectives: To understand how communication with mastologists is perceived and interpreted on diagnosis of a mammary nodule recommended for biopsy. Methods: A qualitative, hermeneutical and critical, study was carried out at a referral center in Recife, in the Brazilian State of Pernambuco. Semistructured interviews were conducted with 16 women aged between 35 and 63 years. Two groups of women were formed (Group 1 with a possible cancer diagnosis and Group 2 without). Results: No woman reported any interest on the part of the physician in her perception of the disease. The relation with the mastologists was satisfactory for Group 1, especially in terms of sincerity and solidarity in providing access to consults and examinations. In Group 2, the perception of a lack of reciprocity was predominant. Doctor-patient communication succeeded principally when there was a need for the health worker to meet scientifically recognized requirements and provide information, with more time being taken and more clarification given with Group 1. The trivialization of a benign nodule by the physician resulted in enormous dissatisfaction among women in Group 2 in terms of information obtained, in particular in the diagnosis and course of action to be taken. Generally speaking, the patient’s right to express an opinion regarding their degree of comfort was disregarded. Conclusions: Doctor-patient communication is informative and paternalistic in nature, with greater attention being given to women suspected to have cancer. None of them, even where very dissatisfied, aimed at an individual treatment project. Dialogue is difficult for doctors and patients.