Prophylactic Mastectomy: The Patient Experience

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DESCRIPTION (provided by applicant): Prophylactic mastectomy (PM) has been shown to reduce the risk of breast cancer 90% in women at high and moderate risk, but its use is limited by low acceptability. Researchers caution that this is a highly personal decision, but patients and providers have little data about psychosocial outcomes of PM. Project goals are: a. To describe the self-perceived benefits of PM and the physical, emotional, and interpersonal impacts; b. To describe the impact of cancer family history and family communication on decision-making for and outcomes of PM; c. To utilize case comparisons to assess the relative influence of medical, psychological, and family factors in determining positive or adverse outcomes of PM; and, d. To produce a monograph based on the qualitative analysis and emphasizing first-person narratives for use by women considering PM and as a tool for health care providers in advising their patients. This project will qualitatively analyze 108 interview narratives from a previously-funded research project on psychological consultation needs of women considering or recovering from PM. The sample includes women with cancer who underwent unilateral PM (n=50), unaffected women who chose bilateral PM (n=21), and women considering PM (n=37). Analysis will utilize issue-oriented and cross-case research methods. Modal and exceptional cases will be developed. A monograph utilizing the narratives and organizing them into user-friendly topic areas for patients will be developed. Reports for providers will also hopefully enhance advice to patients. Future research may assess utility of this material for women considering PM and for health care providers. Data from the project will inform hypothesis formation for future studies of PM.