October 3, 2013 — Despite evidence that contralateral prophylactic mastectomy (CPM) does not improve survival rates, an increasing number of young women with breast cancer elect to remove their healthy breast to avoid recurrence and improve survival.
Researchers surveyed 123 women aged 40 or younger without known bilateral breast cancer who reported having bilateral mastectomy. The purpose of the survey was to better understand how women approach the decision to have CPM. The survey included questions about the women's health history, reason for choosing CPM and knowledge and perceptions about breast cancer. Most of the women (n = 97) had stage I or II breast cancer and 60 percent of tumors were estrogen receptor-positive. Almost all (98 percent) of the women surveyed indicated that desires to decrease their risk for contralateral breast cancer (CBC) prompted their decision to remove the healthy breast. Although 94 percent of the women surveyed said they chose bilateral mastectomy to increase survival, only 18 percent reported thinking that CPM improved survival rates. Almost all of the women surveyed overestimated the actual risk of CBC.
While physicians were identified as the most important sources of information about breast cancer, only one-third of the women cited a desire to follow a physician's recommendations as an extremely or very important factor in their decision. The authors suggest that this survey underscores a need for better risk communication strategies that help patients make decisions based on evidence.
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