Given that young women with breast cancer often have concerns and priorities attributable to their life stage, we conducted a series of interviews to better understanding the surgical decision-making experience among women diagnosed at age ≤40. Women spoke of how the potential effect of an extended recovery was affecting their decision and, in some cases, contributing to decisional conflict. Several women described their worry of leaving cancer cells behind; others cited the need for continued surveillance as a consideration. Attention to situational anxiety and concerns about recurrence are warranted to ensure that decisions are made in a supportive and patient-centered setting.
NashR, GoodmanM, LinCC, et al.State variation in the receipt of a contralateral prophylactic mastectomy among women who received a diagnosis of invasive unilateral early-stage breast cancer in the United States, 2004–2012. JAMA Surg. 2017; 152(7):648–657.
3.
AaldersKC, van BommelAC, van DalenT, et al.Contemporary risks of local and regional recurrence and contralateral breast cancer in patients treated for primary breast cancer. Eur J Cancer. 2016; 63:118–26.
4.
KramerI, SchaapveldM, OldenburgHSA, et al.The influence of adjuvant systemic regimens on contralateral breast cancer risk and receptor subtype. J Natl Cancer Inst. 2019 [Epub ahead of print]; DOI:10.1093/jnci/djz010.
5.
BrewsterAM, ParkerPA. Current knowledge on contralateral prophylactic mastectomy among women with sporadic breast cancer. Oncologist. 2011; 16(7):935–41.
6.
KurianAW, LichtensztajnDY, KeeganTH, et al.Use of and mortality after bilateral mastectomy compared with other surgical treatments for breast cancer in California, 1998–2011. JAMA. 2014; 312(9):902–14.
7.
WongSM, FreedmanRA, SagaraY, et al.Growing use of contralateral prophylactic mastectomy despite no improvement in long-term survival for invasive breast cancer. Ann Surg. 2017; 265(3):581–9.
8.
DegnerLF, KristjansonLJ, BowmanD, et al.Information needs and decisional preferences in women with breast cancer. JAMA. 1997; 277(18):1485–92.
9.
AbbottA, RuethN, Pappas-VarcoS, et al.Perceptions of contralateral breast cancer: an overestimation of risk. Ann Surg Oncol. 2011; 18(11):3129–36.
10.
HawleyST, JanzNK, GriffithKA, et al.Recurrence risk perception and quality of life following treatment of breast cancer. Breast Cancer Res Treat. 2017; 161(3):557–65.
11.
PartridgeA, AdloffK, BloodE, et al.Risk perceptions and psychosocial outcomes of women with ductal carcinoma in situ: longitudinal results from a cohort study. J Natl Cancer Inst. 2008; 100(4):243–51.
12.
FisherCS, Martin-DunlapT, RuppelMB, et al.Fear of recurrence and perceived survival benefit are primary motivators for choosing mastectomy over breast-conservation therapy regardless of age. Ann Surg Oncol. 2012; 19(10):3246–50.
13.
RosenbergSM, TracyMS, MeyerME, et al.Perceptions, knowledge, and satisfaction with contralateral prophylactic mastectomy among young women with breast cancer: a cross-sectional survey. Ann Intern Med. 2013; 159(6):373–81.
14.
CovelliAM, BaxterNN, FitchMI, et al.“Taking control of cancer”: understanding women's choice for mastectomy. Ann Surg Oncol. 2015; 22(2):383–91.
15.
SandoIC, BilligJI, AmbaniSW, et al.An evaluation of the choice for contralateral prophylactic mastectomy and patient concerns about recurrence in a reconstructed cohort. Ann Plast Surg. 2017; 80(4):333–338.
16.
RendleKA, HalleyMC, MaySG, FroschDL. Redefining risk and benefit: understanding the decision to undergo contralateral prophylactic mastectomy. Qual Health Res. 2015; 25(9):1251–9.
17.
CristJV, GrunfeldEA. Factors reported to influence fear of recurrence in cancer patients: a systematic review. Psychooncology. 2013; 22(5):978–86.
18.
WaljeeJF, RogersMA, AldermanAK. Decision aids and breast cancer: do they influence choice for surgery and knowledge of treatment options?. J Clin Oncol. 2007; 25(9):1067–73.
19.
BelkoraJK, VolzS, TengAE, et al.Impact of decision aids in a sustained implementation at a breast care center. Patient Educ Couns. 2012; 86(2):195–204.
20.
WhelanT, LevineM, WillanA, et al.Effect of a decision aid on knowledge and treatment decision making for breast cancer surgery: a randomized trial. JAMA. 2004; 292(4):435–41.
21.
LamWW, ChanM, OrA, et al.Reducing treatment decision conflict difficulties in breast cancer surgery: a randomized controlled trial. J Clin Oncol. 2013; 31(23):2879–85.
22.
ManneSL, SmithBL, FrederickS, et al.B-Sure: a randomized pilot trial of an interactive web-based decision support aid versus usual care in average-risk breast cancer patients considering contralateral prophylactic mastectomy. Transl Behav Med. 2019 [Epub ahead of print]; DOI:10.1093/tbm/iby133.
23.
HawleyST, JagsiR, MorrowM, et al.Social and clinical determinants of contralateral prophylactic mastectomy. JAMA Surg. 2014; 149(6):582–9.
24.
ParkerPA, PetersonSK, BedrosianI, et al.Prospective study of surgical decision-making processes for contralateral prophylactic mastectomy in women with breast cancer. Ann Surg. 2016; 263(1):178–83.
