Bilateral prophylactic mastectomy decision making: A vignette study

Michael Stefanek, Cheryl Enger, Judith Benkendorf, Susan Flamm Honig, Caryn Lerman

Research output: Contribution to journalArticlepeer-review

32 Scopus citations


Background. Little is known about the perception of bilateral prophylactic mastectomy (BPM), and whether perceptions are influenced by a family history of breast cancer. It is also unclear what factors may play a role in selecting BPM for follow-up care. Methods. Samples of predominantly Caucasian, well-educated women with (n = 129) and without (n = 104) family histories of breast cancer were provided a vignette of a woman at increased risk. They selected one of two follow-up options: (1) clinical breast examination, breast self exam, and annual mammography or (2) BPM. Results. The samples did not differ on the decision to select BPM (29.5% vs 22.1%). The family history sample reported worry about breast cancer as a problem (34.4%) more often than women with no history (15.7%). Multivariate analysis found worry and estimated 10-year risk of the woman in the vignette as significant predictors of selecting BPM. Conclusions. Approximately 25% of our sample selected BPM as the preferred option. The majority supported the need to discuss BPM among women at increased risk. Finally, both factors associated with the selection of BPM (worry, risk assessment) are potentially amenable to psychosocial or educational approaches. There is a clear need for assessment of worry and risk perception prior to surgical decision making.

Original languageEnglish (US)
Pages (from-to)216-221
Number of pages6
JournalPreventive Medicine
Issue number3
StatePublished - Sep 1999
Externally publishedYes


  • Bilateral prophylactic mastectomy
  • Breast cancer
  • Family history
  • Risk perception
  • Worry

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health


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