PREDICTORS OF AND SATISFACTION WITH BILATERAL PROPHYLACTIC MASTECTOMY

Background. Women with a first-degree relative with breast cancer are at increased risk of developing this disease. The optimal medical mana gement 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 bilate ral mastectomy, very little is known about satisfaction with this surg ery. Also, we know very little about variables related to prophylactic mastectomy decision making. Methods. Participants were women at incre ased risk of breast cancer due to family history. These women were cat egorized by self-report as not interested in prophylactic mastectomy ( n = 58), interested but deciding against surgery (n = 92), or subseque ntly having a bilateral prophylactic mastectomy (n = 14). Information on screening practices, risk. perception, level of depression, and can cer-related worry was collected. Women completing prophylactic mastect omy reported on their satisfaction with the surgery and breast reconst ruction. Results. Women selecting surgery reported more breast cancer worry. The group expressing no interest in surgery reported fewer biop sies and lower risk estimates. Women completing surgery were satisfied with their decision, although satisfaction with reconstruction was mi xed. Conclusion. Factors influencing surgical decision making may incl ude breast-cancer-related worry, biopsy history, and subjective breast cancer risk. (C) 1995 Academic Press, Inc.