{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T16:19:57Z","timestamp":1782836397213,"version":"3.54.5"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100017219","name":"Schneider-Lesser Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100017219","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["P30 CA008748"],"award-info":[{"award-number":["P30 CA008748"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psycho-Oncology"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Approximately half of Nigerian women with non\u2010metastatic breast cancer undergo surgery, yet psychosocial factors influencing mastectomy receipt are poorly understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study aimed to understand barriers, facilitators, and patient attitudes toward mastectomy for breast cancer in Nigeria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Using a prospective, convergent mixed\u2010methods study design, we disseminated a structured questionnaire (\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a0225) and conducted in\u2010depth interviews (\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a018) among women with non\u2010metastatic breast cancer recommended for mastectomy at 3 academic Nigerian institutions. Logistic regression identified factors associated with mastectomy within 1\u00a0year of diagnosis; interviews were analyzed using the framework method. Qualitative and quantitative themes were triangulated using a joint display.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Median age was 48\u00a0years (IQR 40,57); median tumor size was 6.6\u00a0cm (IQR 4.4,10.1). One hundred patients (44%) underwent mastectomy, 97 within 1 year of diagnosis. Nineteen percent (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a042\/224) had not heard of breast cancer before diagnosis; 37% (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a082\/223) had not heard of mastectomy. Interview participants expressed negative emotions toward mastectomy. Of those who did not receive surgery, the most common reasons were cost (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a041\/125, 33%), loss to follow\u2010up (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a020\/125, 16%), traditional medicine (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a013\/125, 10%), death (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a012\/125, 9.6%), and disease progression (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a09\/125, 7.2%). In multivariable analysis, awareness of mastectomy (OR 4.10, 95% CI 1.64,10.7,\n                      <jats:italic>p<\/jats:italic>\n                      \u2010value\u00a0=\u00a00.003) was significantly associated with surgery receipt within 1\u00a0year.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study identified patient factors related to mastectomy receipt, including education and awareness, financial burden, fear of surgery, anticipated body image changes, and concern about adverse social impacts. Public health education about breast cancer surgery, pre\u2010mastectomy counseling\/peer\u2010support, and financial may facilitate mastectomy receipt.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pon.70413","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T06:58:15Z","timestamp":1773817095000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Mastectomy for Breast Cancer in Nigeria: A Mixed\u2010Methods Study of Barriers, Facilitators, and Patient Attitudes"],"prefix":"10.1002","volume":"35","author":[{"given":"Anya","family":"Romanoff","sequence":"first","affiliation":[{"name":"Department of Global Health and Health System Design Icahn School of Medicine Mount Sinai  New York New York USA"},{"name":"Global Cancer Disparities Initiatives Department of Surgery Memorial Sloan Kettering Cancer Center  New York New York 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