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Type: Journal article
Title: Intention to undergo prophylactic bilateral mastectomy in women at increased risk of developing hereditary breast cancer
Author: Meiser, B.
Butow, P.
Friedlander, M.
Schnieden, V.
Gattas, M.
Kirk, J.
Suthers, G.
Haan, E.
Tucker, K.
Citation: Journal of Clinical Oncology, 2000; 18(11):2250-2257
Publisher: Amer Soc Clinical Oncology
Issue Date: 2000
ISSN: 0732-183X
Statement of
By Bettina Meiser, Phyllis Butow, Michael Friedlander, Vivienne Schnieden, Michael Gattas, Judy Kirk, Graeme Suthers, Eric Haan, and Katherine Tucker
Abstract: PURPOSE: To assess intention to undergo prophylactic bilateral mastectomy and psychologic determinants in unaffected women at increased risk of developing hereditary breast cancer. PATIENTS AND METHODS: Three hundred thirty-three women who were awaiting their initial appointments for risk assessment, advice about surveillance, and prophylactic options at one of 14 familial cancer clinics participated in a cross-sectional, questionnaire-based survey. RESULTS: Nineteen percent of women would consider and 47% would not consider a prophylactic mastectomy, should genetic testing identify a mutation in a breast cancer–predisposing gene, whereas 34% were unsure and 1% had already undergone a prophylactic mastectomy. In a bivariate analysis, women at a moderately increased risk of developing breast cancer had the highest proportion of subjects reporting that they would consider a prophylactic mastectomy (25%), compared with women at high risk (16%) (χ2 = 7.79; P = .051). In multivariate analyses, consideration of prophylactic mastectomy strongly correlated with high levels of breast cancer anxiety (odds ratio [OR] = 17.4; 95% confidence interval [CI], 4.35 to 69.71; P = .0001) and overestimation of one’s breast cancer risk (OR = 3.01; 95% CI, 1.43 to 6.32; P = .0036), whereas there was no association with objective breast cancer risk (P = .60). CONCLUSION: A significant proportion of women at increased risk of developing hereditary breast cancer would consider prophylactic mastectomy. Although prophylactic mastectomy may be appropriate in women at high risk of developing breast cancer, it is perhaps less so in those who have a moderately increased risk. Such moderate-risk women are likely to benefit from interventions aimed at reducing breast cancer anxiety and correcting exaggerated breast cancer risk perceptions.
Keywords: Humans
Breast Neoplasms
Logistic Models
Risk Assessment
Chi-Square Distribution
Cross-Sectional Studies
Health Knowledge, Attitudes, Practice
Middle Aged
Surveys and Questionnaires
Rights: © 2000 by American Society of Clinical Oncology.
DOI: 10.1200/JCO.2000.18.11.2250
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