title: Women's preferences for contralateral prophylactic mastectomy: An  investigation using protection motivation theory.
abstract: OBJECTIVE
  Most women diagnosed with unilateral breast cancer without BRCA1 or BRCA2 mutations are at low risk of contralateral breast cancer. Contralateral Prophylactic Mastectomy (CPM) decreases the relative risk of contralateral breast cancer, but may not increase life expectancy; yet international uptake is increasing. This study applied protection motivation theory (PMT) to determine factors associated with women's intentions to undergo CPM.
  
  
  METHODS
  Three hundred eighty-eight women previously diagnosed with unilateral breast cancer and of negative or unknown BRCA1 or BRCA2 status were recruited from an advocacy group's research database. Participants completed measures of PMT constructs based on a common hypothetical CPM decision-making scenario.
  
  
  RESULTS
  PMT constructs explained 16% of variance in intentions to undergo CPM. Response efficacy (CPM's advantages) and response costs (CPM's disadvantages) were unique individual predictors of intentions.
  
  
  CONCLUSIONS
  Decision-making appears driven by considerations of the psychological, cosmetic and emotional advantages and disadvantages of CPM. Overestimations of threat to life from contralateral breast cancer and survival benefit from CPM also appear influential factors.
  
  
  CONCLUSIONS
  Patients require balanced and medically accurate information regarding the pros and cons of CPM, survival rates, and recurrence risks to ensure realistic and informed decision-making.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Tesson
authors.forename: Imogen
authors.initials: I
authors.lastname: Richards
authors.forename: David
authors.initials: D
authors.lastname: Porter
authors.forename: Kelly-Anne
authors.initials: KA
authors.lastname: Phillips
authors.forename: Nicole
authors.initials: N
authors.lastname: Rankin
authors.forename: Toni
authors.initials: T
authors.lastname: Musiello
authors.forename: Michelle
authors.initials: M
authors.lastname: Marven
authors.forename: Phyllis
authors.initials: P
authors.lastname: Butow
mesh_terms: D000328:Adult; D001315:Australia; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006801:Humans; D033182:Intention; D008017:Life Expectancy; D008875:Middle Aged; D009042:Motivation; D057240:Patient Preference; D000072036:Prophylactic Mastectomy / Q000523:psychology*; D011582:Psychological Theory; D018570:Risk Assessment; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D000069584:Unilateral Breast Neoplasms / Q000175:diagnosis* / Q000523:psychology / Q000601:surgery*