title: International variation in physicians' attitudes towards prophylactic mastectomy - comparison between France, Germany, the Netherlands and the United Kingdom.
abstract: OBJECTIVE
  Prophylactic mastectomy (PM) has proven to be the most effective method to reduce the risk of breast cancer in high-risk women. The present study aimed to present and compare the attitudes towards PM among physicians in France, Germany, the Netherlands and the United Kingdom (UK).
  
  
  METHODS
  An international sample of 1196 general practitioners (GPs) and 927 breast surgeons (BS) were surveyed using a mailed questionnaire.
  
  
  RESULTS
  Only 30% of the French and 27% of the German GPs were of opinion that PM should be an option for an unaffected female BRCA1/2 mutation carrier, as compared to 85% and 92% of the GPs in the Netherlands and UK, respectively. Similarly, 78% of the French and 66% of the German BS reported a positive attitude towards PM, as compared to 100% and 97% of the BS in the Netherlands and UK, respectively. In the whole sample of GPs, a positive attitude towards PM was associated with country of residence, being female, and having more knowledge of breast/ovarian cancer genetics, while among BS there was a positive association with country of residence and having more knowledge of breast/ovarian cancer genetics as well, and, in addition, with a higher number of newly diagnosed breast cancer patients last year.
  
  
  CONCLUSIONS
  These results demonstrated the international variations in the attitude towards PM among physicians. This might reflect that different policies are adopted to prevent breast cancer in women at-risk.
authors.affiliation: Department of Clinical Genetics, Erasmus Medical Centre, Rotterdam, The Netherlands. m.denheijer@erasmusmc.nl
authors.forename: M
authors.initials: M
authors.lastname: Den Heijer
authors.forename: C J
authors.initials: CJ
authors.lastname: van Asperen
authors.forename: H
authors.initials: H
authors.lastname: Harris
authors.forename: I
authors.initials: I
authors.lastname: Nippert
authors.forename: J
authors.initials: J
authors.lastname: Schmidtke
authors.forename: A D
authors.initials: AD
authors.lastname: Bouhnik
authors.forename: C
authors.initials: C
authors.lastname: Julian-Reynier
authors.forename: D G
authors.initials: DG
authors.lastname: Evans
authors.forename: A
authors.initials: A
authors.lastname: Tibben
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D019313:BRCA1 Protein / Q000235:genetics; D024682:BRCA2 Protein / Q000235:genetics; D001943:Breast Neoplasms / Q000235:genetics / Q000517:prevention & control*; D016009:Chi-Square Distribution; D003466:Cultural Characteristics; D005060:Europe; D005260:Female; D020022:Genetic Predisposition to Disease; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008408:Mastectomy / Q000379:methods*; D008875:Middle Aged; D015999:Multivariate Analysis; D009154:Mutation; D012111:Residence Characteristics; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires
chemical_list: D019313:BRCA1 Protein; C492913:BRCA1 protein, human; D024682:BRCA2 Protein; C551750:BRCA2 protein, human
keywords: Breast cancer; France; Germany; International variation; Physicians’ attitudes; Prophylactic mastectomy; Surgeons; The Netherlands; The UK