title: Motivations for contralateral prophylactic mastectomy as a function of socioeconomic status.
abstract: Despite no demonstrated survival advantage for women at average risk of breast cancer, rates of contralateral prophylactic mastectomy (CPM) continue to increase. Research reveals women with higher socioeconomic status (SES) are more likely to select CPM. This study examines how indicators of SES, age, and disease severity affect CPM motivations.
  
  
  
  Patients (N = 113) who underwent CPM at four Indiana University affiliated hospitals completed telephone interviews in 2013. Participants answered questions about 11 CPM motivations and provided demographic information. Responses to motivation items were factor analyzed, resulting in 4 motivational factors: reducing long-term risk, symmetry, avoiding future medical visits, and avoiding treatments.
  
  
  
  Across demographic differences, reducing long-term risk was the strongest CPM motivation. Lower income predicted stronger motivation to reduce long-term risk and avoid treatment. Older participants were more motivated to avoid treatment; younger and more-educated patients were more concerned about symmetry. Greater severity of diagnosis predicted avoiding treatments.
  
  
  
  Reducing long-term risk is the primary motivation across groups, but there are also notable differences as a function of age, education, income, and disease severity. To stop the trend of increasing CPM, physicians must tailor patient counseling to address motivations that are consistent across patient populations and those that vary between populations.
authors.affiliation: Department of Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Emerson Hall 202, Indianapolis, IN, 46202, USA.|Present address: William Beaumont Hospital, 3601 W 13 Mile Rd, Royal Oak, MI, 48073, USA.
authors.forename: Dadrie F
authors.initials: DF
authors.lastname: Baptiste
authors.affiliation: Department of Communication Arts and Sciences, Pennsylvania State University, 234 Sparks Building, University Park, PA, 16802, USA.
authors.forename: Erina L
authors.initials: EL
authors.lastname: MacGeorge
authors.affiliation: Brian Lamb School of Communication, Purdue University, BRNG 2264, 100 North University Street, West Lafayette, IN, 47907-2098, USA.
authors.forename: Maria K
authors.initials: MK
authors.lastname: Venetis
authors.affiliation: Brian Lamb School of Communication, Purdue University, BRNG 2264, 100 North University Street, West Lafayette, IN, 47907-2098, USA.
authors.forename: Ashton
authors.initials: A
authors.lastname: Mouton
authors.affiliation: Brian Lamb School of Communication, Purdue University, BRNG 2264, 100 North University Street, West Lafayette, IN, 47907-2098, USA.|Present address: Department of Communication and Media, Texas A&M-Corpus Christi, 6300 Ocean Dr., Corpus Christi, TX, 78412, USA.
authors.forename: L Brooke
authors.initials: LB
authors.lastname: Friley
authors.affiliation: Brian Lamb School of Communication, Purdue University, BRNG 2264, 100 North University Street, West Lafayette, IN, 47907-2098, USA.|Present address: CoreClarity, PO Box 863692, Plano, TX, 75086, USA.
authors.forename: Rebekah
authors.initials: R
authors.lastname: Pastor
authors.affiliation: Brian Lamb School of Communication, Purdue University, BRNG 2264, 100 North University Street, West Lafayette, IN, 47907-2098, USA.|Present address: School of Communication, Western Michigan University, 1903 W Michigan Ave., Kalamazoo, MI, 49008, USA.
authors.forename: Kristen
authors.initials: K
authors.lastname: Hatten
authors.affiliation: Department of Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Emerson Hall 202, Indianapolis, IN, 46202, USA.|Present address: Ariadne Labs, 401 Park Drive, Boston, MA, 02215, USA.
authors.forename: Janaka
authors.initials: J
authors.lastname: Lagoo
authors.affiliation: Department of Surgery, Feinberg School of Medicine, Northwestern University, 303 E. Superior Street, Lurie 4-113, Chicago, IL, 60611, USA. susan.clare@northwestern.edu.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Clare
authors.affiliation: Department of Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Emerson Hall 202, Indianapolis, IN, 46202, USA. modb27@yahoo.com.|Present address: Hendricks Regional Health, 1000 East Main Street, Danville, IN, 46122, USA. modb27@yahoo.com.
authors.forename: Monet W
authors.initials: MW
authors.lastname: Bowling
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000517:prevention & control* / Q000523:psychology; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D007196:Indiana; D008875:Middle Aged; D009042:Motivation; D000072036:Prophylactic Mastectomy / Q000523:psychology* / Q000639:trends; D044469:Racial Groups / Q000523:psychology; D020379:Risk Adjustment / Q000379:methods; D012923:Social Class; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology / Q000706:statistics & numerical data
keywords: Breast cancer; Contralateral prophylactic mastectomy; Motivation; Socioeconomic