Women diagnosed with breast cancer and who have the disease surgically treated by mastectomy experience a health crisis. This thesis focused on the behaviours, feelings and attitudes of women during their breast cancer and mastectomy experiences. The overall purpose was to identify therapeutic factors that can be used by health professionals to improve the psychological and physiological well-being of women with this disease. The conceptual scaffolding for the thesis was drawn from the fields of perceptual psychology and decision-making. The thesis was supported by a study that examined specific areas concerning the breast cancer and mastectomy experience. These areas were self-perceptions, the psychological milieu resulting from a breast cancer diagnosis, and post-mastectomy breast restoration decision-making. The population included: a prosthesis group of 64 women who had mastectomies and wore external breast prostheses, a reconstruction group of 31 women who had mastectomies and underwent breast reconstructions, a control A group of 75 women who had not experienced mastectomy, and a control B group of 65 women who also had not experienced mastectomy. Self-perceptions: The perceptions of the prosthesis, reconstruction and control A groups regarding their body-image, self-concept, total self-image, and self-esteem were compared by using Polivy's (1977) Body-Image Scale and Rosenberg's (1965) Self-Esteem Scale. The body-image, total self-image, and self-esteem mean scores indicated that the prosthesis and reconstruction groups had more positive feelings regarding their bodies than did the control group. There were no significant differences in self-concept among the three groups. These findings challenge a common assumption that mastectomy automatically results in psychiatric morbidity caused by an altered body-image and suggest that health professionals should not make assumptions about how a woman will psychologically respond to mastectomy. Quality of life perceptions were compared among the prosthesis, reconstruction and control B groups using the Ferrans and Powers (1985) Quality of Life Index. The mean scores of the prosthesis and reconstruction groups were higher than the control group's scores, with higher scores indicating more positive quality of life perceptions. The findings suggest that the women in the mastectomy samples had found ways to cope with their health crises. Over time, they learned not to define all existence in terms of a cancer diagnosis and had gained or maintained a positive perspective on life. Post-mastectomy attitudes in the prosthesis and the reconstruction groups were compared. Using the Mastectomy Attitude Scale the results indicated that both groups were satisfied with their bodies, had a positive outlook towards their lives, implied that sexuality entailed more than having breasts, and felt that mastectomy treatment was necessary to save their lives. Neither group concealed that they had a mastectomy, nor were the women prone to discuss their mastectomy experiences. The findings from the study indicate that the women post-mastectomy already had or developed positive attitudes towards themselves and life in general and the method chosen for breast restoration had no apparent impact on these attitudes. The self-perception data indicated that women do adjust and cope with breast cancer surgically treated by mastectomy. These women should be encouraged by health professionals to develop a helping relationship with other women who are newly diagnosed with the disease. This alliance could engender hope in those women who are beginning their journey along a similar road to survival. More hope for these women and less fatalism would decrease their sense of crisis and facilitate their abilities to take an active part in the decision-making processes relating to their treatment. Psychological Milieu: The women in the prosthesis and the reconstruction groups were interviewed about their breast cancer and mastectomy experiences. The findings supported the premise that receiving a diagnosis of breast cancer plunged the women into a health crisis and caused an instant disruption to their lives. The women found that they had to suddenly deal with several complex issues all at the same time, such as what must be done in the immediate future to treat the cancer, as well as the more frightening issues of the meaning of the illness on their ultimate life expectancy. All of this turmoil played havoc with their ability to make informed decisions regarding their breast cancer treatment alternatives. This finding suggests the need for more individualised interventions and support for women when they are making decisions during this stressful period. Health professionals need to keep in mind that simply hearing the word "cancer" often prevents a person from assimilating the complete diagnosis, indicated treatments, and possible prognosis. Therefore, care-givers must be prepared to repeat and elaborate upon information previously given to the affected individual and the family. Breast Restoration Decision-Making: To evaluate the prosthesis and the reconstruction groups' abilities to undertake competent breast restoration decision-making, a 5 Stage process was devised, modelled after Janis and Mann's (1977) seven criteria for competent decision-making. Analysis of the data revealed that both groups displayed passive information seeking behaviour in relation to breast restoration alternatives. They had either no knowledge or limited knowledge regarding the alternatives. Their lack of knowledge was due either to (1) anxiety about their disease, or (2) deficiencies in the interpersonal skills of individuals presenting information to them, or (3) the perceptions that they had insufficient time to gather information, or (4) a combination of these factors. Because the prosthesis and the reconstruction groups were under stress they used coping styles to accomplish decision-making. To measure their coping styles five categories were defined, based on Janis and Mann's (1977) conflict model of emergency decisionmaking and Simon's (1957) notion of "bounded rationality". Two styles emerged. The prosthesis group used the "Sideliner" style that allowed the women to make a quick, conflict-free decision. They were not aware of alternative choices resulting in their decision-making experience being uncomplicated and effortless. The reconstruction group used the "Contented" style that also allowed them an uncomplicated and effortless decision-making experience. The women decided that breast reconstruction was their only viable option. Many of them did not even think that they had made a decision about an alternative because of the strong salience towards breast reconstruction. A breast restoration decision-making model has been developed and proposed for women to use when considering their alternatives. This model offers to health professionals and women a realistic and useable decision-making process that can be implemented when individuals are experiencing a health crisis. The model can be modified and used for numerous situations that require decisions regarding treatment alternatives. This inquiry has demonstrated that there is a need for a specific health professional to assist women newly diagnosed with breast cancer. This individual would assume several roles that include one of advocacy for the women, and the important role of ensuring that these individuals have the information and knowledge to make competent decisions regarding their breast cancer treatments.