An exploration of Australian psychologists' role in assessing women considering risk-reducing or contralateral prophylactic mastectomy

Braude, Lucy; Laidsaar-Powell, Rebekah; Gilchrist, Jemma; Kirsten, Laura; Juraskova, Ilona

doi:10.1016/j.breast.2017.01.011

Cited by 10 publications

(22 citation statements)

References 25 publications

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“…Whilst cost is a barrier to psychological consultation, if it benefits women's decision‐making and acceptance of post‐surgery outcomes and reduces the demands on surgeon's time pre and post‐surgery thereby reducing healthcare costs, the need for routine psychological intervention may be justified …”

Section: Discussionmentioning

confidence: 99%

“…As standard practice it will likely lead to fewer psychological adjustment issues post‐surgery . This could be cost effective and enable surgical consultation time to be used more effectively and efficiently . Further research supporting routine psychological consultation could assist in policy recommendations that encourage health care providers to subsidize the cost of psychological consultation for all women undergoing BPM.…”

Section: Discussionmentioning

confidence: 99%

“…Previous research found women believe psychological consultation should be mandatory, although they stress the importance of a therapist who has knowledge of familial cancer and BPM . Psychological consultation prior to BPM provides the opportunity to discuss psychosocial concerns, which surgeons do not necessarily have the time or skills to do . Routine psychological consultation could be cost‐effective, reducing demands on surgeon's time during consultations …”

Section: Introductionmentioning

confidence: 99%

“…Psychological consultation prior to BPM provides the opportunity to discuss psychosocial concerns, which surgeons do not necessarily have the time or skills to do . Routine psychological consultation could be cost‐effective, reducing demands on surgeon's time during consultations …”

Section: Introductionmentioning

confidence: 99%

“…6 Psychological consultation prior to BPM provides the opportunity to discuss psychosocial concerns, which surgeons do not necessarily have the time or skills to do. 21 Routine psychological consultation could be cost-effective, reducing demands on surgeon's time during consultations. 6,21 To our knowledge, no research has explored the provision of psychological support specifically related to undergoing BPM, irrespective of whether genetic counselling was available.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Perceived influence of psychological consultation on psychological well‐being, body image, and intimacy following bilateral prophylactic mastectomy: A qualitative analysis

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Perceived influence of psychological consultation on psychological well‐being, body image, and intimacy following bilateral prophylactic mastectomy: A qualitative analysis

et al. 2017

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The development of a template for psychological assessment of women considering risk‐reducing or contralateral prophylactic mastectomy: A national Delphi consensus study

et al. 2018

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Reframing the conversation about contralateral prophylactic mastectomy: Preparing women for postsurgical realities

et al. 2018

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Objective: Women with unilateral, early-stage breast cancer and low genetic risk are increasingly opting for contralateral prophylactic mastectomy (CPM), a concerning trend because CPM offers few clinical benefits while increasing risks of surgical complications. Few qualitative studies have analyzed factors motivating this irreversible decision. Using qualitative methods, this study sought to understand women's decision making and the impact of CPM on self-confidence, sense of femininity, sexual intimacy, and peace of mind.Methods: Women who had CPM within the last 10 years were recruited to participate in the study. We conducted a thematic analysis of the data.Results: Forty-five women were interviewed. When making the decision for CPM, most had incomplete knowledge of potential negative outcomes. However, all believed CPM had more benefits than harms and would confer the most peace of mind and the fewest regrets should cancer return. They knew their contralateral breast cancer risk was low but were not persuaded by statistics. They wanted to do everything possible to reduce their risk of another breast cancer, even by a minimal amount, but most reported paying an unexpectedly high price for this small reduction in risk. Nevertheless, 41 of 45 reported that they would make the same decision again.Conclusions: These findings highlight an opportunity for physicians to reframe the conversation to focus on the patient experience of the tradeoffs of CPM rather than statistical odds of future cancers. Our findings suggest that more data may not dissuade women from CPM but may better prepare them for its outcomes. KEYWORDS breast cancer, breast cancer surgery, cancer, contralateral prophylactic mastectomy, CPM, decision-making, oncology, psychosocial, quality of life, surgery

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An exploration of Australian psychologists' role in assessing women considering risk-reducing or contralateral prophylactic mastectomy

Cited by 10 publications

References 25 publications

Perceived influence of psychological consultation on psychological well‐being, body image, and intimacy following bilateral prophylactic mastectomy: A qualitative analysis

Perceived influence of psychological consultation on psychological well‐being, body image, and intimacy following bilateral prophylactic mastectomy: A qualitative analysis

The development of a template for psychological assessment of women considering risk‐reducing or contralateral prophylactic mastectomy: A national Delphi consensus study

Reframing the conversation about contralateral prophylactic mastectomy: Preparing women for postsurgical realities

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