Psychosocial factors associated with the uptake of contralateral prophylactic mastectomy among BRCA1/2 mutation noncarriers with newly diagnosed breast cancer Journal Article


Authors: Hamilton, J. G.; Genoff, M. C.; Salerno, M.; Amoroso, K.; Boyar, S. R.; Sheehan, M.; Fleischut, M. H.; Siegel, B.; Arnold, A. G.; Salo-Mullen, E. E.; Hay, J. L.; Offit, K.; Robson, M. E.
Article Title: Psychosocial factors associated with the uptake of contralateral prophylactic mastectomy among BRCA1/2 mutation noncarriers with newly diagnosed breast cancer
Abstract: Purpose: Women who are newly diagnosed with breast cancer may consider contralateral prophylactic mastectomy (CPM) to reduce their future risk of cancer in their unaffected breast. Pre-surgical BRCA1/2 genetic testing can provide valuable risk information to guide this choice. However, little is understood about why BRCA1/2 mutation noncarriers, who are generally not at substantially elevated risk of contralateral disease, select CPM. Methods: We examined the uptake of CPM among breast cancer patients identified as BRCA1/2 mutation noncarriers (n = 92) as part of a larger prospective study of the impact of pre-surgical BRCA1/2 testing. Data obtained from self-report questionnaires and patient medical records were used to examine associations between theoretically relevant background and psychosocial factors and BRCA1/2 mutation noncarriers’ decisions to undergo CPM. Results: Among BRCA1/2 mutation noncarriers, 25% (n = 23) elected to undergo CPM. Psychosocial factors including a self-reported physician recommendation for CPM, greater perceived contralateral breast cancer risk, and greater perceived benefits of CPM were all significantly associated with the uptake of CPM. Conclusions: A sizeable minority of BRCA1/2 mutation noncarriers choose to undergo CPM after learning their mutation status through pre-surgical genetic testing. BRCA1/2 mutation noncarriers’ cognitive perceptions and social influences appear to be important in shaping their decisions regarding CPM. This work highlights the importance of several psychosocial factors in influencing patients’ surgical decisions. Future research is needed that examines the formation of BRCA1/2 mutation noncarriers’ beliefs regarding their disease and available treatment options, and that characterizes the physician-patient communication that occurs in this complex decision-making context. © 2017, Springer Science+Business Media New York.
Keywords: breast cancer; genetic testing; prevention; decision-making; prophylactic mastectomy
Journal Title: Breast Cancer Research and Treatment
Volume: 162
Issue: 2
ISSN: 0167-6806
Publisher: Springer  
Date Published: 2017-04-01
Start Page: 297
End Page: 306
Language: English
DOI: 10.1007/s10549-017-4123-x
PROVIDER: scopus
PMCID: PMC5329117
PUBMED: 28150129
DOI/URL:
Notes: Article -- Export Date: 4 April 2017 -- Source: Scopus
Altmetric Score
MSK Authors
  1. Kenneth Offit
    507 Offit
  2. Mark E Robson
    365 Robson
  3. Jennifer L Hay
    161 Hay
  4. Angela Arnold
    24 Arnold
  5. Sherry R Boyar
    4 Boyar
  6. Margaux Christine Genoff
    13 Genoff
  7. Beth   Siegel
    8 Siegel