title: A Woman's Decision to Choose Bilateral Mastectomy.
abstract: BACKGROUND
  Rates of bilateral mastectomy as treatment for unilateral breast cancer have been rising. Quantitative analyses have resulted in assumptions about why women choose this procedure, without confirmation from the women.
  
  
  OBJECTIVE
  The objective of this study was to explore a woman's decision making in the choice of bilateral mastectomy as a treatment for unilateral breast cancer, regardless of stage.
  
  
  METHODS
  A qualitative descriptive design was used. In-depth interviews were conducted by 2 researchers using a semistructured interview guide to elicit data, which were coded and analyzed using thematic analysis.
  
  
  RESULTS
  Twenty-three women were interviewed. Five themes were identified that address specific determinants of the decision-making process: finding something, collecting evidence, perceived level of risk, identifying priorities, and making the decision. Nine women reported that their physicians recommended bilateral mastectomy.
  
  
  CONCLUSIONS
  Women who recalled being advised of their risk of recurrence reported overestimates of that risk. The reasons women chose bilateral mastectomy were to avoid a lifetime of follow-up screenings with the subsequent fear of hearing that the breast cancer had returned and wanting to stay alive and well for their children and families.
  
  
  CONCLUSIONS
  Except for women carrying genetic susceptibility to breast cancer, bilateral mastectomy is not considered the standard of care. Yet women are being offered or choosing this procedure. Nurses can be advocates for women by speaking positively about how women have the right to choose their treatment based on best evidence and personal choice. This evidence should include benefits and risks of the treatment.
authors: Author Affiliations: School of Nursing-Camden (Drs Jerome-D'Emilia and Suplee) and School of Social Work, Rutgers University, Camden, New Jersey (Ms Boiler); and CancerCare of Southern New Jersey, Cherry Hill (Dr D'Emilia).
authors: Bonnie
authors: B
authors: Jerome-D'Emilia
authors: Patricia D
authors: PD
authors: Suplee
authors: Jennifer L K
authors: JL
authors: Boiler
authors: John C
authors: JC
authors: D'Emilia
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000235:genetics / Q000601:surgery*; D002755:Choice Behavior; D005260:Female; D006801:Humans; D008408:Mastectomy / Q000379:methods / Q000523:psychology*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010817:Physician-Patient Relations; D036301:Qualitative Research; D018570:Risk Assessment