Glassey Rachael, O'Connor Moira, Ives Angela, Saunders Christobel, Hardcastle Sarah J
Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia.
WA Centre for Cancer & Palliative Care, School of Psychology, Curtin University, Perth, Australia.
Patient Educ Couns. 2018 Feb;101(2):318-323. doi: 10.1016/j.pec.2017.08.008. Epub 2017 Aug 24.
The objective of this study was to explore the influences on decision-making of younger women (<35) undergoing or considering bilateral prophylactic mastectomy (BPM).
Qualitative interviews guided by interpretative phenomenological analysis (IPA) were conducted with forty-six women who had a strong family history of breast cancer (BC) who had either undergone (n=26) or were considering (n=20) BPM. Participants were recruited from Australia and New Zealand (NZ) via hospitals, a genetics clinic, a research cohort, a registry and online.
Four themes underpinning the influences on decision-making were identified: fear and anxiety, children, personal experiences with BC, health professional's influence.
The decision to undergo BPM for younger women (<35) was multifaceted, however, it appeared that fear and anxiety were the main influence. Younger women appear more anxious than previous research with older women. There appears to be few differences between those with confirmed BRCA1/2 mutations and those with no known mutation and this is clinically significant.
These findings have important practice implications, particularly improving communication of risk statistics, especially to those with no known mutation. Health professionals need to take into account the way younger women perceive information given to them when discussing risk.
本研究的目的是探讨对接受或考虑双侧预防性乳房切除术（BPM）的年轻女性（<35岁）决策的影响。
采用解释现象学分析（IPA）指导的定性访谈，对46名有乳腺癌（BC）家族史且已接受（n = 26）或正在考虑（n = 20）BPM的女性进行访谈。参与者通过医院、遗传诊所、研究队列、登记处和网络从澳大利亚和新西兰（NZ）招募。
确定了影响决策的四个主题：恐惧和焦虑、子女、BC个人经历、医疗专业人员的影响。
年轻女性（<35岁）接受BPM的决策是多方面的，然而，恐惧和焦虑似乎是主要影响因素。年轻女性似乎比之前对老年女性的研究更焦虑。在有确诊BRCA1/2突变的女性和无已知突变的女性之间似乎没有差异，这在临床上具有重要意义。
这些发现具有重要的实践意义，特别是改善风险统计信息的沟通，尤其是对那些无已知突变的女性。医疗专业人员在讨论风险时需要考虑年轻女性对所提供信息的理解方式。
