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Related Experiment Videos

Physicians-in-training recommendations for prophylactic bilateral mastectomies.

Atul K Madan1, Shaghayegh Aliabadi-Wahle, Derrick J Beech

  • 1Department of Surgery, Tulane University School of Medicine, Tulane University, New Orleans, LA, USA.

The Breast Journal
|September 13, 2003
PubMed
Summary

Physician bias may affect recommendations for bilateral prophylactic mastectomy (PBM). This study found male physicians-in-training were more likely than females to recommend PBM for breast cancer prevention.

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Area of Science:

  • Oncology
  • Medical Ethics
  • Surgical Oncology

Background:

  • Bilateral prophylactic mastectomy (PBM) is a strategy to reduce breast carcinoma risk.
  • Physician bias may influence PBM recommendations.
  • Understanding physician-in-training perspectives on PBM is crucial for equitable patient care.

Purpose of the Study:

  • To investigate potential biases among physicians-in-training regarding recommendations for bilateral prophylactic mastectomy (PBM).
  • To determine if personal risk perception influences PBM recommendations differently for patients versus self or significant others.

Main Methods:

  • A survey was administered to second-year medical students, general surgical residents, and internal medicine residents.
  • Participants indicated the breast carcinoma risk percentage at which they would recommend PBM for patients, themselves, and significant others.

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  • 198 physicians-in-training completed the survey, with data analyzed using univariate and multivariate methods.

    • Main Results:

    • Both physician-in-training type and gender were initially associated with PBM recommendation risk thresholds.
    • Multivariate analysis revealed only gender remained significantly associated with PBM recommendation risk (p<0.05).
    • Male physicians-in-training were more likely than females to recommend PBM for breast cancer prevention.
    • PBM was recommended at lower risk thresholds for significant others compared to self (67.5% vs. 57.2%).
    • Recommendations for self/significant others closely mirrored those for patients.

    Conclusions:

    • Gender is a significant factor influencing physicians-in-training's recommendations for bilateral prophylactic mastectomy.
    • Male physicians-in-training demonstrate a tendency towards recommending PBM at lower risk levels compared to females.
    • Further research is needed to address potential gender-based disparities in PBM recommendations and patient counseling.