Redefining Risk and Benefit: Understanding the Decision to Undergo Contralateral Prophylactic Mastectomy. Qual Health Res 2015 Sep;25(9):1251-9
Date
11/06/2014Pubmed ID
25371380DOI
10.1177/1049732314557085Scopus ID
2-s2.0-84939174562 (requires institutional sign-in at Scopus site) 28 CitationsAbstract
Rates of contralateral prophylactic mastectomy (CPM) among unilateral breast cancer patients are rapidly increasing; however, there are little data documenting the decision-making process of patients with no known BRCA mutations, who elect this more aggressive treatment. We conducted semistructured interviews with nine newly diagnosed patients who elected CPM over other surgical options. Using grounded theory, we analyzed interview data to identify influential decision-making factors by prevalence and intensity across participants. Decision-making factors included subjective evaluations of risk and benefit, avoidance of future breast cancer surveillance and accompanying worry, and desire to maintain (or improve) breast appearance. Based solely on survival benefit, the decision to undergo CPM might be viewed as unnecessary or even misguided. However, our findings show the importance of psychosocial factors in patients' assessments of risk and benefit, and support the need for additional patient-provider communication regarding these factors.
Author List
Rendle KA, Halley MC, May SG, Frosch DLAuthor
Meghan C. Halley PhD, BA, MPH Assistant Professor in the Institute for Health and Humanity department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultBreast Neoplasms
Decision Making
Female
Health Knowledge, Attitudes, Practice
Humans
Interviews as Topic
Middle Aged
Physician-Patient Relations
Prophylactic Mastectomy
Risk Assessment
San Francisco
Women's Health
