Department of Psychology, Center for Science Communication Research, University of Oregon, Eugene, OR, USA.
Department of Plastic and Reconstructive Surgery, College of Medicine, Division of Health Services Management and Policy, College of Public Health, OSU Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA.
Med Decis Making. 2023 Feb;43(2):152-163. doi: 10.1177/0272989X221121134. Epub 2022 Sep 5.
Rates of contralateral prophylactic mastectomy (CPM)-removal of the healthy breast following breast cancer diagnosis-have increased, particularly among women for whom CPM provides no survival benefit. Affective (i.e., emotional) decision making is often blamed for this increase. We studied whether greater negative breast cancer affect could motivate uptake of CPM through increased cancer risk perceptions and biased treatment evaluations.
We randomly assigned healthy women with average breast-cancer risk ( = 1030; M = 44.14, SD = 9.23 y) to 1 of 3 affect conditions (negative v. neutral v. positive narrative manipulation) in a hypothetical online experiment in which they were asked to imagine being diagnosed with cancer in one breast. We assessed 1) treatment choice, 2) affect toward CPM, and 3) perceived risk of future breast cancer in each breast (cancer affected and healthy) following lumpectomy, single mastectomy, and CPM.
The manipulation caused women in the negative and neutral narrative conditions (26.9% and 26.4%, respectively) to choose CPM more compared with the positive narrative condition (19.1%). Across conditions, women's CPM affect did not differ. However, exploratory analyses addressing a possible association of affect toward cancer-related targets suggested that women in the negative narrative condition may have felt more positively toward CPM than women in the positive narrative condition. The manipulation did not have significant effects on breast cancer risk perceptions.
The manipulation of affect had a small effect size, possibly due to the hypothetical nature of this study and/or strong a priori knowledge and attitudes about breast cancer and its treatment options.
Increased negative affect toward breast cancer increased choice of CPM over other surgical options and might have motivated more positive affective evaluations of CPM.
This study used narratives to elicit different levels of negative integral affect toward breast cancer to investigate the effects of affect on breast cancer treatment choices.Increased negative affect toward breast cancer increased the choice of double mastectomy over lumpectomy and single mastectomy to treat a hypothetical, early-stage cancer.The narrative manipulation of negative affect toward breast cancer did not change the perceived risks of future cancer following any of the surgical interventions.Negative affect toward breast cancer may have biased affective evaluations of double mastectomy.
对侧预防性乳房切除术（CPM）——在乳腺癌诊断后切除健康乳房——的比例有所增加，尤其是在 CPM 对生存没有益处的女性中。人们常常将这种增加归咎于情感（即情绪）决策。我们研究了更大的负面乳腺癌影响是否可以通过增加对癌症风险的认知和对治疗的偏见评估来促使 CPM 的采用。
我们在一项假设性的在线实验中，随机分配平均乳腺癌风险的健康女性（n = 1030；M = 44.14，SD = 9.23 岁）至 3 种影响条件之一（负面叙事、中性叙事、正面叙事），让她们想象自己在一侧乳房中被诊断出患有癌症。我们评估了 1）治疗选择、2）对 CPM 的影响、以及 3）保乳手术后、单乳房切除术和 CPM 后每侧乳房（受影响和健康）未来乳腺癌的风险感知。
负面和中性叙事条件下的女性（分别为 26.9%和 26.4%）比正面叙事条件下的女性（19.1%）更倾向于选择 CPM。在所有条件下，女性对 CPM 的影响并没有差异。然而，对可能与癌症相关目标的情感关联的探索性分析表明，负面叙事条件下的女性可能对 CPM 的评价比正面叙事条件下的女性更积极。该操作对乳腺癌风险认知没有显著影响。
影响的操作具有较小的效应量，这可能是由于这项研究的假设性质以及对乳腺癌及其治疗选择的强烈先验知识和态度。
对乳腺癌的负面整体情感的增加增加了对 CPM 的选择，而不是其他手术选择，并且可能对 CPM 的更积极的情感评估产生了影响。
本研究使用叙事来引出对乳腺癌的不同程度的负面整体情感，以研究情感对乳腺癌治疗选择的影响。对乳腺癌的负面情感增加了双乳房切除术而非保乳术和单乳房切除术治疗假设的早期癌症的选择。对乳腺癌的负面情感的叙事操作并未改变任何手术干预后的未来癌症风险感知。对乳腺癌的负面情感可能会影响对双乳房切除术的情感评估。
