Predictors of uptake of contralateral prophylactic mastectomy in women with nonhereditary breast cancer.


Journal

Cancer
ISSN: 1097-0142
Titre abrégé: Cancer
Pays: United States
ID NLM: 0374236

Informations de publication

Date de publication:
15 Nov 2019
Historique:
received: 08 05 2019
revised: 21 06 2019
accepted: 27 06 2019
pubmed: 23 8 2019
medline: 27 5 2020
entrez: 23 8 2019
Statut: ppublish

Résumé

The rates of contralateral prophylactic mastectomy (CPM) are increasing in women with breast cancer. Previous retrospective research has examined clinical and demographic predictors of the uptake of CPM. However, to the authors' knowledge, there has been very little prospective research to date that has examined psychosocial functioning prior to breast cancer surgery to determine whether psychosocial functioning predicts uptake of CPM. The current study was conducted to evaluate demographic, clinical, and psychosocial predictors of the uptake of CPM in women with unilateral breast cancer without a BRCA1 or BRCA2 mutation. Women with unilateral non-BRCA-associated breast cancer completed questionnaires prior to undergoing breast cancer surgery. Participants completed demographic and psychosocial questionnaires assessing anxiety, depression, cancer-related distress, optimism/pessimism, breast satisfaction, and quality of life. Pathological and surgical data were collected from medical charts. A total of 506 women consented to participate, 112 of whom (22.1%) elected to undergo CPM. Age was found to be a significant predictor of CPM, with younger women found to be significantly more likely to undergo CPM compared with older women (P < .0001). The rate of CPM was significantly higher in women with noninvasive breast cancer compared with those with invasive breast cancer (P < .0001). Women who elected to undergo CPM had lower levels of presurgical breast satisfaction (P = .01) and optimism (P = .05) compared with women who did not undergo CPM. Psychosocial functioning at the time of breast cancer surgery decision making impacts decisions related to CPM. Women who have lower levels of breast satisfaction (body image) and optimism are more likely to elect to undergo CPM. It is important for health care providers to take psychosocial functioning into consideration when discussing surgical options.

Sections du résumé

BACKGROUND BACKGROUND
The rates of contralateral prophylactic mastectomy (CPM) are increasing in women with breast cancer. Previous retrospective research has examined clinical and demographic predictors of the uptake of CPM. However, to the authors' knowledge, there has been very little prospective research to date that has examined psychosocial functioning prior to breast cancer surgery to determine whether psychosocial functioning predicts uptake of CPM. The current study was conducted to evaluate demographic, clinical, and psychosocial predictors of the uptake of CPM in women with unilateral breast cancer without a BRCA1 or BRCA2 mutation.
METHODS METHODS
Women with unilateral non-BRCA-associated breast cancer completed questionnaires prior to undergoing breast cancer surgery. Participants completed demographic and psychosocial questionnaires assessing anxiety, depression, cancer-related distress, optimism/pessimism, breast satisfaction, and quality of life. Pathological and surgical data were collected from medical charts.
RESULTS RESULTS
A total of 506 women consented to participate, 112 of whom (22.1%) elected to undergo CPM. Age was found to be a significant predictor of CPM, with younger women found to be significantly more likely to undergo CPM compared with older women (P < .0001). The rate of CPM was significantly higher in women with noninvasive breast cancer compared with those with invasive breast cancer (P < .0001). Women who elected to undergo CPM had lower levels of presurgical breast satisfaction (P = .01) and optimism (P = .05) compared with women who did not undergo CPM.
CONCLUSIONS CONCLUSIONS
Psychosocial functioning at the time of breast cancer surgery decision making impacts decisions related to CPM. Women who have lower levels of breast satisfaction (body image) and optimism are more likely to elect to undergo CPM. It is important for health care providers to take psychosocial functioning into consideration when discussing surgical options.

Identifiants

pubmed: 31435939
doi: 10.1002/cncr.32405
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

3966-3973

Informations de copyright

© 2019 American Cancer Society.

Références

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Auteurs

Kelly A Metcalfe (KA)

Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
Women's College Research Institute, Toronto, Ontario, Canada.

Helene Retrouvey (H)

Division of Plastic Surgery, University Health Network and Mount Sinai Hospital, Toronto, Ontario, Canada.

Isabel Kerrebijn (I)

Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada.

Kate Butler (K)

Division of Plastic Surgery, University Health Network and Mount Sinai Hospital, Toronto, Ontario, Canada.

Anne C O'Neill (AC)

Division of Plastic Surgery, University Health Network and Mount Sinai Hospital, Toronto, Ontario, Canada.

Tulin Cil (T)

Division of General Surgery, Princess Margaret Hospital, Toronto, Ontario, Canada.

Toni Zhong (T)

Division of Plastic Surgery, University Health Network and Mount Sinai Hospital, Toronto, Ontario, Canada.

Stefan O P Hofer (SOP)

Division of Plastic Surgery, University Health Network and Mount Sinai Hospital, Toronto, Ontario, Canada.

David R McCready (DR)

Division of General Surgery, Princess Margaret Hospital, Toronto, Ontario, Canada.

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