Women’s preferences for contralateral prophylactic mastectomy: An investigation using protection motivation theory

Surgical treatment of early stage breast cancer in the Auckland and Waikato regions of New Zealand

“…Reasons why women choose bilateral surgery are related to clinical, psychological and cosmetic outcomes, anxiety surrounding future treatments, family history and being BRCA or other gene mutation positive . Fear of recurrence and a misperception of enhanced survival are major influences, with younger women more anxious than older women and therefore more likely to opt for bilateral mastectomy . In the current cohort, 80% of women who had unilateral breast cancer but opted for bilateral surgery were <60 years of age, and as age increased, the likelihood of having a bilateral mastectomy decreased.…”

“…Only 586 women underwent bilateral surgery, and 290 (50%) of these did not have bilateral cancer. Bilateral mastectomy reduces the risk of contralateral breast cancer following unilateral disease, but does not increase survival in BRCA1/2 mutation negative women . Reasons why women choose bilateral surgery are related to clinical, psychological and cosmetic outcomes, anxiety surrounding future treatments, family history and being BRCA or other gene mutation positive .…”

“…Bilateral mastectomy reduces the risk of contralateral breast cancer following unilateral disease, but does not increase survival in BRCA1/2 mutation negative women . Reasons why women choose bilateral surgery are related to clinical, psychological and cosmetic outcomes, anxiety surrounding future treatments, family history and being BRCA or other gene mutation positive . Fear of recurrence and a misperception of enhanced survival are major influences, with younger women more anxious than older women and therefore more likely to opt for bilateral mastectomy .…”

“…A small number of women are diagnosed with cancer in both breasts and undergo bilateral surgery – usually bilateral mastectomy. In some cases, women with unilateral disease choose bilateral mastectomy to prevent cancer in the other breast, despite no clinical evidence to support any further survival benefit . In addition, an increasing option for women choosing mastectomy is to have immediate breast reconstruction, using either autologous techniques (deep inferior epigastric perforator (DIEP) artery flaps, transverse rectus abdominis myocutaneous (TRAM) flaps and latissimus dorsi (LD) flaps) or implant‐based reconstruction…”

Contralateral prophylactic mastectomy (CPM): A systematic review of patient reported factors and psychological predictors influencing choice and satisfaction

“…In order to aid the development of future interventions, future studies ought to include a theoretical framework to understand health decisions in addition to validated measures to assess psychological constructs that may influence decisions. One study [48] has considered Protection Motivation Theory to predict intentions to have CPM using a hypothetical scenario after previous research has demonstrated its utility in predicting intentions for genetic testing [49] and chemoprevention [49] for breast cancer.…”