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To explore the pretreatment thoughts and behaviors of women newly diagnosed with breast cancer regarding their surgical treatment decision-making experience.Qualitative, descriptive.A multispecialty breast center in the midwestern region of the United States.18 English-speaking women, aged 37–87 years, mean of 12 days postdiagnosis of clinical stage 0-II breast cancer.Open to semistructured interviews were conducted during the period following surgical consultation but prior to surgical treatment. Transcribed interviews, originally analyzed to identify the psychological processes of women in response to breast cancer diagnosis, were additionally analyzed using directed content analysis focusing on women's thoughts and behaviors related to their surgical treatment decision-making process.Breast cancer surgery and decision making pretreatment.Women's pretreatment thoughts and behaviors related to surgical treatment decision making were characterized by information processing, contemplating options, and interacting with others. Breast cancer information was used by women before the surgical consultation and after treatment decisions had been made. Treatment options were contemplated and preferences formed often before the initial surgical consultation. Women associated having options with a better prognosis. Age was a factor primarily in the type of information women desired.Most women made their own surgical treatment decisions with ease, supported by the confidence instilled by their surgeons and oncology nurses.The findings provide oncology nurses with insight regarding women's desire for and use of information and their contemplation of surgical options, therefore suggesting areas on which to focus clinical assessment and to test tailored interventions.