Glassey Rachael, O'Connor Moira, Ives Angela, Saunders Christobel, O'Sullivan Sarah, Hardcastle Sarah J
Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, M507, 35 Stirling Highway, Crawley, Perth, WA, Australia.
School of Psychology and Speech Pathology, Curtin University, Perth, Australia.
Fam Cancer. 2018 Jan;17(1):15-22. doi: 10.1007/s10689-017-0001-2.
The objective of this study was to explore the factors that influence perceived personal risk of developing breast cancer (BC) in younger women (<35) who are considering or have undergone bilateral prophylactic mastectomy (BPM). Qualitative interviews guided by interpretative phenomenological analysis were conducted with 46 women who had a strong family history of BC and had either undergone (n = 26) or were considering (n = 20) BPM. Participants were recruited from Australia and New Zealand via hospitals, a genetics clinic, a research cohort, a registry and online. Three main themes were identified: information that increases fear of BC and death, underlying anxiety and fear and screening anxiety. A further two themes: relief following surgery and confusion about residual risk following surgery were identified. Younger women (<35) appeared to have heightened and sometimes inaccurate perceptions of their BC risk. They appeared less relieved of anxiety and fear of developing BC by BPM surgery, in comparison to previous research with older women (>40). Those who had undergone BPM seemed more anxious about their risk of developing BC than those who were still considering surgery. This research has important implications for practice, particularly improving communication of accurate risk statistics. Future research should examine why some women interpret information differently and explore the benefits of psychological consultation for very anxious women.
本研究的目的是探讨在考虑或已接受双侧预防性乳房切除术（BPM）的年轻女性（<35岁）中，影响其对患乳腺癌（BC）个人风险感知的因素。采用解释现象学分析进行定性访谈，对象为46名有乳腺癌家族史且已接受（n = 26）或正在考虑（n = 20）BPM的女性。参与者通过医院、遗传学诊所、研究队列、登记处和网络从澳大利亚和新西兰招募。确定了三个主要主题：增加对乳腺癌和死亡恐惧的信息、潜在的焦虑和恐惧以及筛查焦虑。还确定了另外两个主题：手术后的缓解以及对手术后残余风险的困惑。年轻女性（<35岁）似乎对自己患乳腺癌的风险有更高且有时不准确的认知。与之前对年长女性（>40岁）的研究相比，她们似乎较少因BPM手术而缓解对患乳腺癌的焦虑和恐惧。那些已接受BPM的女性似乎比仍在考虑手术的女性更担心自己患乳腺癌的风险。这项研究对实践具有重要意义，特别是在改善准确风险统计信息的沟通方面。未来的研究应探讨为什么有些女性对信息的解读不同，并探索为焦虑程度很高的女性提供心理咨询的益处。
