Doctors can operate on a mentally ill woman who does not accept her breast cancer diagnosis, a judge has ruled.
The woman, who is in her 60s and has paranoid schizophrenia, maintains she "has a cyst".
Bosses at the University Hospitals of North Midlands NHS Trust in Staffordshire asked Mr Justice Keehan for a ruling.
The judge decided surgery was in the woman's best interests and specialists said she was likely to die without it.
The woman, who has not been identified, believed medics treating her were "actors or impostors".
The judge explained his decision in a written ruling, after analysing the case at a hearing at the Court of Protection in early October, where lawyers representing doctors and the woman submitted evidence.
Mr Justice Keehan said he was satisfied the woman had breast cancer and that surgery was the right option.
Hospital chiefs had asked the judge to rule that the woman did not have the mental capacity to make treatment decisions and that surgery was in her best interests.
The woman was represented by staff from the office of the Official Solicitor, who help people who lack the mental capacity to make decisions.