News: Most women make mastectomy decision early on

Most women being tested for mutations in the breast cancer antigen (BRCA) genes have already decided their preferred course of action before learning the outcome, with the decision being strongly influenced by anticipated feelings of regret in case of a future breast cancer diagnosis, according to a report in the May 10 issue of the Journal of Clinical Oncology.

Sandra van Dijk, PhD, from Leiden University Medical Center in the Netherlands, and colleagues examined risk-management preferences in 338 women who were tested for mutations in the BRCA genes, of which 80 were found to have mutations, before and up to 9 months after testing.

The researchers found that 90% of the women already had a risk-management preference at baseline, whether prophylactic mastectomy or regular breast screening, and this remained stable over time for most women. Risk-management preference was strongly associated with anticipated feelings of regret in case of a future breast cancer diagnosis (OR, 8.93).

van Dijk S, van Roosmalen MS, Otten W, et al. Decision making regarding prophylactic mastectomy: stability of preferences and the impact of anticipated feelings of regret. J Clin Oncol. 2008;26:2358-2363. doi:10.1200/JCO.2006.10.5494.