SIDEBAR: Expect Questions About Contralateral Prophylactic Mastectomy: Carefully Review Risks and Alternatives

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Physicians were considered the most important source of information about contralateral prophylactic mastectomy in a survey of 123 women who were diagnosed with cancer in one breast and chose to have the contralateral procedure. While 80% of the women reported that they spoke with their physicians to at least some extent about the reasons for having contralateral prophylactic mastectomy, only 51% reported that their physicians discussed the reasons not to have the surgery. The survey also found that many women overestimate their risk for cancer in the unaffected breast.

Risk Perception

“Knowing that there is this tendency for people to misperceive risk, I think it becomes that much more important for physicians to very carefully go over the risks and problems associated with additional surgery and carefully go through the potential benefits,” Eric P. Winer, MD, told The ASCO Post in an interview discussing the survey results. Dr. Winer is coauthor of an article in the Annals of Internal Medicine detailing the survey results. He is also Chief of the Division of Women’s Cancers and Director of the Breast Oncology Center at Dana-Farber Cancer Institute and Professor of Medicine at Harvard Medical School in Boston.

He pointed out that that most of those surveyed said they were satisfied with their decisions and that 90% reported they would definitely choose contralateral prophylactic mastectomy if they had to make the choice again.

“So it is not as if they are making these decisions and then most of them were regretting it. But we want to make sure that people are making informed decisions,” Dr. Winer stressed. “Even if it is just a few patients out of 100 who might choose something differently, we want to give them the opportunity to do so by understanding what they are really facing.” ■

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Better Risk Communication Strategies Needed to Ensure Decision to Have Contralateral Prophylactic Mastectomy Is Evidence-Based

Overestimating the risk that cancer in one breast will affect the other breast may cause many young women with breast cancer to choose contralateral prophylactic mastectomy even though most know it does not clearly improve survival. In a survey of 123 women who were diagnosed with cancer in one...




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