Contralateral prophylactic mastectomy (CPM): A systematic review of patient reported factors and psychological predictors influencing choice and satisfaction.
OBJECTIVE
Conduct a systematic review of quantitative and qualitative studies exploring patient reported factors and psychological variables influencing the decision to have contralateral prophylactic mastectomy (CPM), and satisfaction with CPM, in women with early stage breast cancer.


METHODS
Studies were identified via databases: Medline, CINAHL, Embase and PsycINFO. Data were extracted by one author and crosschecked by two additional authors for accuracy. The quality of included articles was assessed using standardised criteria by three authors.


RESULTS
Of the 1346 unique citations identified, 17 were studies that met the inclusion criteria. Studies included were primarily cross-sectional and retrospective. No study utilised a theoretical framework to guide research and few studies considered psychological predictors of CPM. Fear of breast cancer was the most commonly cited reason for CPM, followed by cosmetic reasons such as desire for symmetry. Overall, women appeared satisfied with CPM, however, adverse/diminished body image, poor cosmetic result, complications, diminished sense of sexuality, emotional issues and perceived lack of education regarding alternative surveillance/CPM efficacy were cited as reasons for dissatisfaction.


CONCLUSIONS
Current literature has begun to identify patient-reported reasons for CPM; however, the relative importance of different factors and how these factors relate to the process underlying the decision to have CPM are unknown. Of women who considered CPM, limited information is available regarding differences between those who proceed with or ultimately decline CPM.
School of Psychology, The University of Sydney, Australia. Electronic address: bage4508@uni.sydney.edu.au.
Brittany
B
Ager
Centre for Medical Psychology and Evidence Based Decision-Making, The University of Sydney, Australia; Psycho-Oncology Co-operative Research Group (PoCoG), The University of Sydney, Australia.
Phyllis
P
Butow
Psycho-Oncology Co-operative Research Group (PoCoG), The University of Sydney, Australia; Sydney Medical School, The University of Sydney, Australia.
Jesse
J
Jansen
Division of Cancer Medicine, Peter MacCallum Cancer Centre, Victoria, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Victoria, Australia.
Kelly-Anne
KA
Phillips
Dept of Medical Oncology, Auckland Hospital, Auckland, New Zealand; Faculty of Medical and Health Sciences, The University of Auckland, New Zealand.
David
D
Porter
D001828:Body Image / Q000523:psychology; D001943:Breast Neoplasms / Q000517:prevention & control* / Q000523:psychology* / Q000601:surgery; D002755:Choice Behavior; D004644:Emotions; D005239:Fear; D005260:Female; D006801:Humans; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D000072036:Prophylactic Mastectomy / Q000009:adverse effects / Q000523:psychology*; D019529:Sexuality / Q000523:psychology
Contralateral prophylactic mastectomy; Patient attitudes; Systematic review