Driel, Catheleine M.G. van (2012) PREDICTORS OF PROPHYLACTIC MASTECTOMY. thesis, Medicine.
Full text available on request.Abstract
Introduction: Women who carry the BRCA1/2 mutation have a high risk of breast cancer. They have to make the difficult decision whether or not to undergo preventive mastectomy. Although preventive mastectomy is a very effective strategy in reducing the risk of breast cancer, it also has a large impact on physical en psychological wellbeing of women. The alternative to preventive mastectomy is an intensive breast-screening program. The goal of screening is not to prevent cancer, but to detect it in an early treatable stage. Limited data are available about the determinants of preventive mastectomy. The purpose of the here presented study is to gain more knowledge about the determinants associated with the decision to undergo preventive mastectomy or not. Methods: 477 women are included in this study. These women visited the family cancer clinic of the university medical centre Groningen between April 1994 to November 2011. All women who were included are BRCA1/2 mutation carriers. The data regarding social demographic characteristics, medical history and medical family history concerning hereditary cancer were recorded. We compared the group that chose preventive mastectomy to the group who did not. Next to that the main reasons the women stated for under going preventive mastectomy were collected. Results: Among the 477 women with a BRCA1/2 mutation, 147 underwent preventive mastectomy at some point. 330 women opted for intensive breast screening. Women of a younger age (<50 years) were more likely to undergo preventive mastectomy. Also women with young children (<12 years old) were more likely to undergo preventive mastectomy. Having a sister with breast cancer also makes the decision to undergo preventive mastectomy more likely. Having ovarian cancer in the family makes a woman less likely to undergo preventive mastectomy. Lastly a previous case of breast cancer and therapeutic mastectomy in the personal history have a statically significant relationship with undergoing preventive mastectomy. In a multivariate analysis, only having young children (<12 years old) and having a case of previous breast cancer were significantly associated with prophylactic mastectomy. Risk reduction was the most mentioned reason for the decision to undergo preventive mastectomy followed by the fear of (death due to) breast cancer. Slightly less frequent, but also the first non-cancer related reason was feeling a reluctance towards undergoing regular surveillance. Conclusion: Following a multivariate analysis among 477 BRCA1/2 mutation carriers, having young children (<12 years old) and having a case of previous breast cancer were significantly associated with the decision to undergo preventive mastectomy. Risk reduction and a fear of (death due to) breast cancer were the most mentioned reasons for the decision to undergo preventive mastectomy.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Bock, Prof. dr. G.H. de onco-epidemiologist and Vries, Dr. J. de surgical oncologist and Jaspers, Dr. J.P.C. medical psychologist and Department of Epidemiology/Surgical Oncology and University Medical Centre Groningen |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:43 |
| Last Modified: | 25 Jun 2020 10:43 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/506 |
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