Decision making for breast cancer prevention among women at elevated risk.
Decision making for breast cancer prevention among women at elevated risk.
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DOI：
10.1186/s13058-017-0826-5
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发表时间：
2017-03-24
期刊：
影响因子：
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通讯作者：
Paskett ED
中科院分区：
文献类型：
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作者：
Padamsee TJ;Wills CE;Yee LD;Paskett ED
几种医疗管理方法已被证明可以有效预防乳腺癌，并在高危妇女中早期发现：1）预防性乳房切除术; 2）预防性卵巢切除术; 3）化学预防; 4）加强筛查程序。然而，在不同程度上，相对于临床实践建议，这些方法基本上未被充分使用。本文回顾了现有的研究，这些预防方法的摄取，妇女谁可能使用各种方法的特点，以及决策过程中，妇女的不同选择的基础。它还强调了未来研究的重要领域，详细说明了在四个关键领域特别需要的研究类型：记录妇女对自己的风险和预防决策的看法;明确比较可用的预防途径及其可能的健康影响;预防决策的心理，人际和社会过程;以及亚组变化的动态。最终，这项研究可以支持干预措施的发展，更充分地赋予妇女权力，使她们能够做出明智和价值观一致的决定，并走向有利的健康结果。
Several medical management approaches have been shown to be effective in preventing breast cancer and detecting it early among women at elevated risk: 1) prophylactic mastectomy; 2) prophylactic oophorectomy; 3) chemoprevention; and 4) enhanced screening routines. To varying extents, however, these approaches are substantially underused relative to clinical practice recommendations. This article reviews the existing research on the uptake of these prevention approaches, the characteristics of women who are likely to use various methods, and the decision-making processes that underlie the differing choices of women. It also highlights important areas for future research, detailing the types of studies that are particularly needed in four key areas: documenting women’s perspectives on their own perceptions of risk and prevention decisions; explicit comparisons of available prevention pathways and their likely health effects; the psychological, interpersonal, and social processes of prevention decision making; and the dynamics of subgroup variation. Ultimately, this research could support the development of interventions that more fully empower women to make informed and values-consistent decisions, and to move towards favorable health outcomes.