Order of Authors:
Emily, Lucy, Laura, Jemma, Lesley and Ilona
Abstract
Objectives: With a rapid increase in the rates of both Risk-Reducing Mastectomies (RRM) and Contralateral Prophylactic Mastectomies (CPM) to manage breast cancer risk, it is important to understand factors impacting women’s decision-making. Whilst patient-reported decisional factors are well established, views of Healthcare Professionals’ (HPs) working with this clinical population remain unclear. This qualitative study aimed to explore HPs’ perception of women’s decision-making about having RRM/CPM, and associated factors.
Methods: The current study involved the secondary analysis of qualitative data from Braude et al’s study (2017) involving semi-structured interviews (n=14) and a focus group (n=10) with medical and allied health HPs who have had experience treating women considering/undergoing RRM/CPM. Thematic analysis using Framework methods was assisted by NVivo12 software.
Results: Qualitative analysis revealed four interconnected themes perceived by HPs to influence women’s decision-making: 1. Medical and Surgical Factors (Medical information and expectations, Understanding risk, RRM vs CPM, and Surveillance difficulties); 2. Psychological Factors (Survival and fear of cancer, Body image and sexuality, Regaining control, Mental health and wellbeing), 3. Social Factors (Familial experiences, Life stage, Support network, Media, and Culture), and 4. HP Communication and Service Factors (Psychological input, and The ‘team’ approach).
Conclusion: These findings provide important insight into the decision-making experience and needs of women considering these invasive and irreversible medical procedures. The obtained data will inform the development of evidence-based decision-making interventions and resources to help facilitate informed and value-sensitive decisions in this growing clinical population.