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One-Quarter With Early Breast Cancer Strongly Considers CPM

Decision factors most valued include avoiding worry about recurrence, reducing need for surgery

FRIDAY, Aug. 18, 2017 (HealthDay News) — More than half of newly diagnosed patients with early-stage breast cancer consider contralateral prophylactic mastectomy (CPM), with one-quarter considering it strongly, according to a study published online Aug. 15 in Cancer.

Sarah T. Hawley, Ph.D., M.P.H., from the University of Michigan in Ann Arbor, and colleagues identified newly-diagnosed patients with early-stage breast cancer who were treated in 2013 to 2014. A total of 2,578 patients were surveyed about seven months after surgery. Consideration of CPM (strong versus less strong) was the primary outcome.

The researchers found that 25 percent of women reported strong/very strong consideration of CPM, while 29 percent considered it moderately/weakly. There was variation in decision styles, including a rational-intuitive approach to decision making. Avoiding worry about recurrence and reducing the need for more surgery were the factors most valued by women at the time of treatment decision making (82 and 73 percent, respectively). Patients who preferred to make their own decisions, those who valued avoiding worry about recurrence, and those who valued avoiding radiation significantly more often strongly considered CPM, in multivariate analysis; those who reported being more logical and those who valued keeping their breast less often strongly considered CPM.

“The variability in decision styles and values observed in this study suggests that formally evaluating these characteristics at or before the initial treatment encounter could provide an opportunity for improving patient clinician discussions,” the authors write.

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