Bilateral prophylactic mastectomy decision making: A vignette study.

Abstract:

BACKGROUND:Little is known about the perception of bilateral prophylactic mastectomy (BPM), and whether perceptions are influenced by a family history of breast cancer. It is also unclear what factors may play a role in selecting BPM for follow-up care. METHODS:Samples of predominantly Caucasian, well-educated women with (n = 129) and without (n = 104) family histories of breast cancer were provided a vignette of a woman at increased risk. They selected one of two follow-up options: (1) clinical breast examination, breast self exam, and annual mammography or (2) BPM. RESULTS:The samples did not differ on the decision to select BPM (29.5% vs 22.1%). The family history sample reported worry about breast cancer as a problem (34.4%) more often than women with no history (15.7%). Multivariate analysis found worry and estimated 10-year risk of the woman in the vignette as significant predictors of selecting BPM. CONCLUSIONS:Approximately 25% of our sample selected BPM as the preferred option. The majority supported the need to discuss BPM among women at increased risk. Finally, both factors associated with the selection of BPM (worry, risk assessment) are potentially amenable to psychosocial or educational approaches. There is a clear need for assessment of worry and risk perception prior to surgical decision making.

journal_name

Prev Med

journal_title

Preventive medicine

authors

Stefanek M,Enger C,Benkendorf J,Flamm Honig S,Lerman C

doi

10.1006/pmed.1999.0524

subject

Has Abstract

pub_date

1999-09-01 00:00:00

pages

216-21

issue

3

eissn

0091-7435

issn

1096-0260

pii

S0091-7435(99)90524-8

journal_volume

29

pub_type

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