Stefanek M E, Helzlsouer K J, Wilcox P M, Houn F
Oncology Center, Johns Hopkins Hospital, Baltimore, Maryland, USA.
Prev Med. 1995 Jul;24(4):412-9. doi: 10.1006/pmed.1995.1066.
Women with a first-degree relative with breast cancer are at increased risk of developing this disease. The optimal medical management of these women is unclear, with options including close breast cancer screening, bilateral prophylactic mastectomy, or participation in chemoprevention trials. Among women who undergo prophylactic bilateral mastectomy, very little is known about satisfaction with this surgery. Also, we know very little about variables related to prophylactic mastectomy decision making.
Participants were women at increased risk of breast cancer due to family history. These women were categorized by self-report as not interested in prophylactic mastectomy (n = 58), interested but deciding against surgery (n = 92), or subsequently having a bilateral prophylactic mastectomy (n = 14). Information on screening practices, risk perception, level of depression, and cancer-related worry was collected. Women completing prophylactic mastectomy reported on their satisfaction with the surgery and breast reconstruction.
Women selecting surgery reported more breast cancer worry. The group expressing no interest in surgery reported fewer biopsies and lower risk estimates. Women completing surgery were satisfied with their decision, although satisfaction with reconstruction was mixed.
Factors influencing surgical decision making may include breast-cancer-related worry, biopsy history, and subjective breast cancer risk.
有乳腺癌一级亲属的女性患此病的风险增加。这些女性的最佳医疗管理尚不清楚，选择包括密切的乳腺癌筛查、双侧预防性乳房切除术或参与化学预防试验。在接受双侧预防性乳房切除术的女性中，对该手术的满意度知之甚少。此外，我们对与预防性乳房切除术决策相关的变量了解甚少。
参与者为因家族病史而患乳腺癌风险增加的女性。这些女性通过自我报告被分类为对预防性乳房切除术不感兴趣（n = 58）、感兴趣但决定不做手术（n = 92）或随后接受双侧预防性乳房切除术（n = 14）。收集了关于筛查做法、风险认知、抑郁程度和癌症相关担忧的信息。完成预防性乳房切除术的女性报告了她们对手术和乳房重建的满意度。
选择手术的女性报告有更多的乳腺癌担忧。对手术不感兴趣的组报告的活检次数较少且风险估计较低。完成手术的女性对自己的决定感到满意，尽管对重建的满意度不一。
影响手术决策的因素可能包括与乳腺癌相关的担忧、活检史和主观乳腺癌风险。
