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Related Experiment Video

Updated: Jan 14, 2026

Single-Port Robotic-assisted Transaxillary Breast-conserving Surgery: A Prospective, Single-arm, Non-randomized Phase IIa Clinical Trial
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Single-Port Robotic-assisted Transaxillary Breast-conserving Surgery: A Prospective, Single-arm, Non-randomized Phase IIa Clinical Trial

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Understanding Patient Decision-Making in Breast Cancer Surgery: Risk Perception, Communication, and Psychosocial

Eman Sbaity1, Tasnim Diab2, Jana Haroun3

  • 1Department of General Surgery, American University of Beirut Medical Center, Beirut P.O. Box 11-0236, Lebanon.

Medical Sciences (Basel, Switzerland)
|October 24, 2025
PubMed
Summary

Contralateral prophylactic mastectomy (CPM) decisions in the Middle East and North Africa (MENA) region are driven by personal preferences, not clinical risk. Improved risk communication and shared decision-making are crucial for early-stage breast cancer patients.

Keywords:
contralateral prophylactic mastectomydecision-makingmastectomyrisk communicationsurgical methods

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Health Psychology

Background:

  • Contralateral prophylactic mastectomy (CPM) use is increasing globally, despite evidence against it for average-risk patients.
  • Factors influencing CPM decisions in the Middle East and North Africa (MENA) region remain understudied.
  • This study investigates clinical, psychosocial, and communication factors in CPM choices for early-stage breast cancer patients.

Purpose of the Study:

  • To explore factors influencing contralateral prophylactic mastectomy (CPM) decisions among women with early-stage breast cancer in the MENA region.
  • To compare characteristics and decision-making drivers between CPM and unilateral mastectomy (UM) groups.
  • To identify areas for improved patient counseling and surgical planning.

Main Methods:

  • Retrospective study of 253 early-stage breast cancer patients undergoing mastectomy (with or without CPM) at a tertiary care center.
  • Data collection included medical records for clinical/demographic information and patient questionnaires for decision-making factors.
  • Statistical analysis employed chi-square tests and multivariable logistic regression.

Main Results:

  • Women choosing CPM (37/253) were more educated, employed, and had a family history of breast cancer compared to UM patients (216/253).
  • CPM patients more frequently underwent immediate reconstruction and had higher 30-day rehospitalization rates.
  • CPM decisions were patient-driven, prioritizing peace of mind and risk reduction belief, while UM decisions were more physician-influenced.

Conclusions:

  • In the MENA region, CPM choices are primarily influenced by personal preferences over clinical risk assessment.
  • Findings underscore the need for enhanced risk communication and shared decision-making processes.
  • Integrating genetic counseling into surgical planning is recommended to improve patient outcomes and choices.