Introduction In Chile, the Cancer Law recognises the importance of putting patients at the centre and encourages them to participate actively in health care. Participation is a key element to improve patient satisfaction. However, there needs to be more information on how patient participation translates into the medical decision-making process and the clinical encounter. Objective: To analyze the participation experience of women in breast cancer treatment.

Methods A qualitative study was conducted, based on 29 online semi-structured interviews with women undergoing breast cancer treatment from three healthcare centres in Santiago, Chile. The interviews were audio-recorded and analysed through a thematic analysis using the Atlas ti program. Ethical approval was granted at the three hospitals.

Results Two types of participation emerge from the results¹:Participation in the care process, understanding these as all the choices that are made before the start of treatment, which is influenced by economic capacity, information from third parties, urgency of care and ² participation in decision- making about the medical treatment plan, understanding these as all the decisions that women make when it comes to decide the course of treatment, where a high degree of delegation of the decision is observed in the figure of the doctor.

Discussion The participation of women in the decision-making of the medical treatment plan for breast cancer seems to be minimal, prioritising practical criteria of healthcare, that is, in the care process over the choice of medical treatment.

Conclusion The findings contrast with one of the objectives of public cancer policy and with what is reported by global evidence. In this scenario of scarce participation, it is essential to consider how public policy could diminish the possibility of participation by mainly ensuring access to healthcare.