What does risk of future cancer mean to breast cancer patients?

Kaiser, Karen; Cameron, Kenzie A.; Beaumont, Jennifer L.; Garcia, Sofia F.; Lacson, Leilani; Moran, Margaret; Karavites, Lindsey; Rodgers, Chiara; Kulkarni, Swati; Hansen, Nora M.; Khan, Seema A.

doi:10.1007/s10549-019-05182-3

Cited by 12 publications

(15 citation statements)

References 29 publications

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“…Concern about contralateral breast cancer is another reason that patients with breast cancer undergo CPM [ 15 , 16 , 49 , 50 ]. Misconceptions about contralateral breast cancer and CPM benefit may contribute to these decisions, since patient-perceived risk of contralateral breast cancer consistently overestimates actual calculated risk [ 15 , 16 , 60 , 61 ]. In a recent study [ 61 ] breast cancer patients without a BRCA mutation perceived their 10-year risk of contralateral breast cancer to be 22%, nearly four times the actual 10-year risk.…”

Section: Resultsmentioning

confidence: 99%

“…Misconceptions about contralateral breast cancer and CPM benefit may contribute to these decisions, since patient-perceived risk of contralateral breast cancer consistently overestimates actual calculated risk [ 15 , 16 , 60 , 61 ]. In a recent study [ 61 ] breast cancer patients without a BRCA mutation perceived their 10-year risk of contralateral breast cancer to be 22%, nearly four times the actual 10-year risk. On the other hand, a study using in-depth interviews with 45 patients [ 62 ] found that patients knew of their low risk of contralateral breast cancer, but they still wanted CPM.…”

Section: Resultsmentioning

confidence: 99%

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Contralateral prophylactic mastectomy: A narrative review of the evidence and acceptability

et al. 2021

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The uptake of contralateral prophylactic mastectomy (CPM) has increased steadily over the last twenty years in women of all age groups and breast cancer stages. Since contralateral breast cancer is relatively rare and the breast cancer guidelines only recommend CPM in a small subset of patients with breast cancer, the drivers of this trend are unknown. This review aims to evaluate the evidence for and acceptability of CPM, data on patient rationales for choosing CPM, and some of the factors that might impact patient preferences. Based on the evidence, future recommendations will be provided. First, data on contralateral breast cancer risk and CPM rates and trends are addressed. After that, the evidence is structured around four main patient rationales for CPM formulated as questions that patients might ask their surgeon: Will CPM reduce mortality risk? Will CPM reduce the risk of contralateral breast cancer? Can I avoid future screening with CPM? Will I have better breast symmetry after CPM? Also, three different guidelines regarding CPM will be reviewed. Studies indicate a large gap between patient preferences for radical risk reduction with CPM and the current approaches recommended by important guidelines. We suggest a strategy including shared decision-making to enhance surgeons’ communication with patients about contralateral breast cancer and treatment options, to empower patients in order to optimize the use of CPM incorporating accurate risk assessment and individual patient preferences.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Contralateral prophylactic mastectomy: A narrative review of the evidence and acceptability

et al. 2021

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“…For a woman with newly diagnosed breast cancer, the risks of ipsilateral recurrence, distant recurrence, and contralateral breast cancer may be difficult to disentangle. She may confuse one risk for another or frame all risks into a single recurrence risk . This challenging issue may not be adequately addressed by her physicians.…”

Section: Contralateral Breast Cancer Riskmentioning

confidence: 99%

“…Two points should be considered. First, the risk of contralateral breast cancer is often overstated by the patient, possibly owing to inadequate physician-patient discussion . Second, women often disclose a fear of death as the reason for having contralateral mastectomy, despite the lack of a mortality reduction.…”

Section: Distress and Fear Of Recurrencementioning

confidence: 99%

Bilateral Mastectomy in Women With Unilateral Breast Cancer

2021

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“…For example, they reported that in the process of managing uncertainty about their illness and associated mortality, they found ways to regain control and power in their lives by (a) following doctors' orders carefully, (b) relinquishing control to God, (c) coming to terms with their mortality, and (d) focusing their energies on how they want to live in the present moment. Based on our findings and the extant literature, additional strategies to manage uncertainty and/or fear of cancer recurrence may also include helping women more accurately gauge their risk of recurrence (e.g., understand their risk factors), as breast cancer survivors are more likely to overestimate than to underestimate their risk (Kaiser et al, 2019;Liu et al, 2010), potentially experiencing undue distress. Furthermore, mental health professionals should assess fear of recurrence (some assessments are available in Spanish; e.g., Ashing-Giwa & Lim, 2011) or use items on these measures as a starting point for discussion (e.g., identifying triggers such as attending follow-up medical appointments).…”

Section: Mental Health Professionals May Support Womenmentioning

confidence: 81%

“¿Qué viene después?”: Latina women diagnosed with breast cancer twice.

Buki¹,

Ramos²,

Sabet³

et al. 2022

Journal of Latinx Psychology

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There is a growing body of literature on Latina breast cancer survivors. However, little is known about women diagnosed twice. In this qualitative exploratory study, we examined in depth the experiences of five Latina breast cancer survivors diagnosed twice recruited at a community-based organization. Using grounded theory analysis, we identified three themes representing major aspects of their experiences: (a) Experiencing the First and Second Diagnoses, (b) Coping with Breast Cancer, and (c) Living With Uncertainty. Although participants transferred coping skills from their first diagnosis to the second, their experience with the second diagnosis was more challenging. Additionally, living with the uncertainty of a third diagnosis represented a chronic challenge. Overall, participants reported many unmet support needs. Findings raise several implications for research as well as clinical practice and advocacy. In future studies, researchers should consider examining separately the experiences of women diagnosed once from those diagnosed twice. Moreover, research is needed to understand whether the current practice of referring women diagnosed twice to a support group with a majority of women diagnosed once adequately addresses their unique needs. Advocacy is needed to ameliorate financial and language barriers as well as to enhance access to health care for this growing population. Public Significance StatementThe present study suggests that Latina women may find a second breast cancer diagnosis more challenging than the first. A particular psychological burden for these survivors was their chronic fear of a third cancer. In coping with the second diagnosis, they reported receiving less support than they had for the first diagnosis, leaving them with many unmet support needs.

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What does risk of future cancer mean to breast cancer patients?

Cited by 12 publications

References 29 publications

Contralateral prophylactic mastectomy: A narrative review of the evidence and acceptability

Contralateral prophylactic mastectomy: A narrative review of the evidence and acceptability

Bilateral Mastectomy in Women With Unilateral Breast Cancer

“¿Qué viene después?”: Latina women diagnosed with breast cancer twice.

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