A cancer diagnosis signals entry for many patients into the complex and often bewildering world of cancer care. Understanding the role women prefer and their level of satisfaction with the decision-making process at time of diagnosis will help to inform healthcare professionals how to better support breast cancer patients as they navigate the cancer journey. Logistic regression was used to identify significant factors influencing outcomes in role preferences and satisfaction. A complementary method, principal components analysis was used to explore patterns of co-association between outcomes and their influencing factors. Results showed women tended to adopt cancer decision-making roles similar to those used for general health decision-making. Overall, women preferred a collaborative/active role (40/38%) over a passive role (16%). Satisfaction rates were high with 88.1% of women being satisfied/very satisfied with their cancer treatment choice; 89.7% of women satisfied with their decision-making role and; 83.6% satisfied with the information provided to support their decision. Further research involving cohorts of women diagnosed with more advanced disease and for whom decisional regret may be greater, is needed to further explore the link between preferred decision-making role and satisfaction.