title: The relationship between the belief in a genetic cause for breast cancer and bilateral mastectomy.
abstract: OBJECTIVE
  Most women develop causal beliefs following diagnosis with breast cancer and these beliefs can guide decisions around their care and management. Bilateral mastectomy rates are increasing, although the benefits of this surgery are only established in a small percentage of women. In this study we investigated the relationship between causal beliefs and the decision to have a bilateral mastectomy.
  
  
  METHODS
  Women (N = 2,269) from the Army of Women's breast cancer research registry completed an online survey. Women were asked what they believed caused their cancer and responses were coded into 8 causal categories. Participants were also asked about the type of surgery they underwent following their breast cancer diagnosis. The odds ratios for having a double mastectomy were calculated for each causal category using random/bad luck as a referent category.
  
  
  RESULTS
  Hormonal factors (22%) and genetics (19%) were the most common causal belief, followed by don't know (19%), environmental toxins (11%), negative emotions (9%), poor health behavior (8%), other (6%) and random/bad luck (6%). Compared with the referent category, the odds ratio of having a bilateral mastectomy was significantly higher in both the genetics and hormonal causal belief groups (OR = 2.36, 95% CI [1.38, 4.02] and OR = 1.98, 95% CI [1.16, 3.38], respectively).
  
  
  CONCLUSIONS
  Beliefs in a genetic cause for breast cancer are common and are associated with high rates of bilateral mastectomy. This is despite evidence that the actual genetic contribution to breast cancer is much lower than perceived and that bilateral mastectomy is, in most cases, unlikely to improve survival. (PsycINFO Database Record
authors.affiliation: Department of Psychological Medicine, University of Auckland.
authors.forename: Keith J
authors.initials: KJ
authors.lastname: Petrie
authors.affiliation: Division of Mental Health, Norwegian Institute of Public Health.
authors.forename: Solbjørg Makalani
authors.initials: SM
authors.lastname: Myrtveit
authors.affiliation: Dana-Farber Cancer Institute.
authors.forename: Ann H
authors.initials: AH
authors.lastname: Partridge
authors.affiliation: Department of Psychological Medicine, University of Auckland.
authors.forename: Melika
authors.initials: M
authors.lastname: Stephens
authors.affiliation: Department of Psychology, University of California, Los Angeles.
authors.forename: Annette L
authors.initials: AL
authors.lastname: Stanton
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000235:genetics / Q000523:psychology / Q000601:surgery*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008408:Mastectomy / Q000523:psychology*; D008875:Middle Aged; D012042:Registries; D055815:Young Adult