Women's decision-making roles regarding contralateral prophylactic mastectomy.

Area of Science:

• Oncology
• Surgical Oncology
• Patient Decision-Making

Background:

• Contralateral prophylactic mastectomy (CPM) reduces recurrence risk in unilateral breast cancer patients.
• Limited understanding exists regarding women's decision-making roles in CPM.

Purpose of the Study:

• To determine women's decision-making roles in CPM.
• To analyze trends in these roles over time.
• To explore the association between decision-making roles and psychosocial outcomes.

Main Methods:

• Survey of 562 women (aged 18-80) who underwent CPM between 1979-1999.
• Analysis of reported decision-making roles and psychosocial outcomes.
• Examination of trends and associations over time.

Main Results:

• 45% of women made the CPM decision independently; 37% considered physician opinion; 15% shared decisions; 3% deferred to physicians.
• Active decision-making was more common in younger, college-educated, and recently treated women.
• Active roles correlated with higher short-term satisfaction and increased long-term breast cancer concern.

Conclusions:

• Most women actively participate in CPM decisions, especially younger, educated, and recently treated individuals.
• Active roles yield short-term satisfaction but may increase long-term anxiety.
• Further research is needed to explore the link between decision-making roles, clinician input, and patient concern.