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

Braude, Lucy; Kirsten, Laura; Gilchrist, Jemma; Juraskova, Ilona

doi:10.1002/pon.4830

Cited by 4 publications

(8 citation statements)

References 34 publications

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“…Patients equated trauma from hearing they had breast cancer with PTSD and feared that just going for mammograms would trigger similar anguish. Consistent with research showing that misinformation influences women's choices, participants had limited knowledge about the harms of CPM when making their decision …”

Section: Discussionmentioning

confidence: 62%

“…Several studies suggest that physicians might benefit from a deeper understanding of the emotional and psychosocial issues underlying women's surgical decision making and that presurgical counseling be a formal part of treatment for women considering CPM . Although the patients we interviewed did not explicitly report use of counseling at the point of surgical decision making, our qualitative findings as well as the literature suggest that patients would likely benefit from being offered this option, even if their decision for CPM remained unchanged.…”

Section: Discussionmentioning

confidence: 81%

“…Findings from a single institution study suggest that most women with a suspicious finding in their healthy breast on a presurgical MRI chose to forgo a biopsy and proceed directly to CPM, and the majority who had genetic testing chose CPM regardless of the results . Such counterintuitive findings suggest that women's decisions to have CPM are driven by a complex interplay of factors, many of which are not well understood …”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 81%

Section: Introductionmentioning

confidence: 99%

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

et al. 2018

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“…68 Some authors recommend psychological consultations in this population to support decision-making, minimize patient regret, and assess suitability and readiness for surgery. 68 Patients with anxiety or other psychological distress and individuals who experience difficulty with decision-making may especially benefit from this approach. 68…”

Section: Multidisciplinary Care: Who Identifies Assesses and Counsels...mentioning

confidence: 99%

“…68 Patients with anxiety or other psychological distress and individuals who experience difficulty with decision-making may especially benefit from this approach. 68…”

Section: Multidisciplinary Care: Who Identifies Assesses and Counsels...mentioning

confidence: 99%

“Gender Affirmative Surgery: A collaborative approach between the surgeon and mental health professional”

Roblee

Jahromi

Ferragamo³

et al. 2023

Plastic &Amp; Reconstructive Surgery

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Summary: Gender incongruence describes a condition in which an individual’s gender identity does not align with their sex assigned at birth based on anatomic characteristics. Individuals with gender incongruence may request surgical interventions, and gender-affirmation surgery plays an important role for these individuals. The basis of care derives from principles elucidated in the Standards of Care, international guidelines that help inform clinical decision-making. Historically, mental health care professionals (MHCPs) and surgeons have worked collaboratively to select “appropriate” surgical candidates. However, as understanding of gender identity evolves, so does the relationship between the MHCP and the surgeon. The role of the MHCP has shifted from a requirement to verify an individual’s identity to that of supporting and participating in a shared decision-making process between the individual and the health care team. This article discusses the evolution of the relationship between the MHCP and the surgeon and provides insight into the history of this relationship.

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A study on the correlation between Hamilton's depression scale and Zung’s depression anxiety scale of patients with first episode depression

Fan

Sun

Ling

et al. 2020

Asian Journal of Psychiatry

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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

Cited by 4 publications

References 34 publications

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

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

“Gender Affirmative Surgery: A collaborative approach between the surgeon and mental health professional”

A study on the correlation between Hamilton's depression scale and Zung’s depression anxiety scale of patients with first episode depression

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