Contralateral Prophylactic Mastectomy Decision-Making: The Partners' Perspective.
Amanda L Nash, Diane L Bloom, Brittany M Chapman, Stephanie B Wheeler, Kandace P McGuire, Clara N Lee, Kevin Weinfurt, Donald L Rosenstein, Jennifer K Plichta, Julie C Jacobson Vann, E Shelley Hwang
Author Information
Amanda L Nash: Department of Surgery, Duke University Medical Center, Durham, NC, USA. amanda.nash@duke.edu. ORCID
Diane L Bloom: Department of Health Policy and Management, Gillings School of Global Public Health, Chapel Hill, NC, USA.
Brittany M Chapman: Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, USA.
Stephanie B Wheeler: Department of Health Policy and Management, Gillings School of Global Public Health, Chapel Hill, NC, USA.
Kandace P McGuire: Department of Surgery, Virginia Commonwealth University Health, Richmond, VA, USA.
Clara N Lee: Division of Health Services Management and Policy, Department of Plastic and Reconstructive Surgery, OSU Comprehensive Cancer Center, College of Medicine, College of Public Health, The Ohio State University, Columbus, OH, USA.
Kevin Weinfurt: Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
Donald L Rosenstein: Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Jennifer K Plichta: Department of Surgery, Duke University Medical Center, Durham, NC, USA.
Julie C Jacobson Vann: School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
E Shelley Hwang: Department of Surgery, Duke University Medical Center, Durham, NC, USA.
BACKGROUND: The rate of contralateral prophylactic mastectomy (CPM) continues to rise despite no improvement in survival, an increased risk of surgical complications, and negative effects on quality of life. This study explored the experiences of the partners of women who undergo CPM. METHODS: This study was part of an investigation into the factors motivating women with early-stage unilateral breast cancer and low genetic risk to opt for contralateral prophylactic mastectomy (CPM). Participating women were asked for permission to invite their partners to take part in interviews. In-depth interviews with partners were conducted using a semi-structured topic guide. A thematic analysis of the data was performed RESULTS: Of 35 partners, all men, 15 agreed to be interviewed. Most perceived their role to be strong and logical. Some hoped their wives would choose a bilateral mastectomy. All felt strongly that the final decision was up to their partners. The partners often framed the decision for CPM as one of life or death. Thus, any aesthetic effects were unimportant by comparison. The male partners had difficulty grasping the physical and emotional changes inherent in mastectomy, which made communicating about sexuality and intimacy very challenging for the couples. In the early recovery period, some noted the stress of managing home life. CONCLUSIONS: The experiences of the male partners provide insight into how couples navigate complex treatment decision-making, both together and separately. There may be a benefit to including partners in pre- and post-surgical counseling to mitigate miscommunication regarding the expected oncologic and emotional outcomes related to CPM.
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