A Patient-Oriented Exploration of Women's Perspectives on Surgeon Continuity in Breast Cancer Care

Continuity with a single surgeon is considered a key component of patient-centered care, yet little is known about how women with breast cancer perceive and value surgeon continuity compared with team-based models of care. This study explored women’s perspectives on continuity across diagnosis, surgery, and postoperative follow-up within Saskatchewan’s breast cancer care system. Seventeen women who underwent surgical treatment for breast cancer participated in semi-structured interviews. Participants were recruited through social media platforms including breast cancer support groups. The study was analyzed inductively and guided by the Theoretical Domains Framework to allow themes to emerge directly from participants’ accounts. Two patient partners with lived experience contributed to the development of the interview guide, co-interviewing participants, interpretation of findings, and validation of emerging themes to ensure that the results reflected patient priorities. Six themes were identified: trust, relationship, and emotional security through continuity; communication, information, and preparedness; phase-specific preferences for continuity and team-based care; navigating fragmented systems and the burden of self-advocacy; post-surgical support and standard of care; and diagnosis communication through eHealth. Women described continuity with the same surgeon as central to feelings of safety, reassurance, and confidence in decision-making, particularly during diagnosis and surgery. Some participants expressed openness to team-based approaches for postoperative follow-up when communication and coordination were consistent. Fragmented system navigation, inconsistent postoperative support, and impersonal diagnosis communication through eHealth heightened the perceived need for relational continuity. These findings demonstrate that women’s preferences for surgeon-based versus team-based care are influenced by relational, informational, and systemic factors that evolve across the surgical care continuum. The study underscores the importance of developing surgical care pathways that preserve relational continuity while strengthening communication and coordination within multidisciplinary systems.