Table 2 Themes described by health professional and patients that influenced equipoise and recruitment to the trial

Influences on equipoise and recruitment

The treatment landscape has changed—St Gallen consensus and usual care treatment has changed.

Altruism (to help others)—recruited patients;

Timing—too many trials offered

Effects of a lack of equipoise

Health professional preferences and beliefs:

- Impact on patients

- Treatment arms of the trial are so different

Patient preferences reinforced by health professionals—‘we can save your breast’

Diagnostic journey doubts