Support needs and acceptability of psychological and peer consultation: Attitudes of 108 women who had undergone or were considering prophylactic mastectomy

Andrea F. Patenaude, Sara Orozco, Xiaochun Li, Carolyn M. Kaelin, Michelle Gadd, Yvedt Matory, Kathleen Mayzel, Constance A. Roche, Barbara L. Smith, Walden Farkas, Judy E. Garber

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Objective: Prophylactic mastectomy (PM) offers 90% or greater reduction in risk of breast cancer to women at increased hereditary risk. Nonetheless, acceptance in North America is low (0-27%) and 25-50% of women electing surgery report psychological distress and/or difficulty adapting following PM. Most women also report reduced cancer worry postoperatively. Psychological consultation to aid decision-making and post-surgical coping is not routinely offered. This retrospective, cross-sectional study explored interest in and acceptability of psychological consultation for issues related to PM among 108 women who had undergone or were considering surgery. Method: Qualitative interviews were conducted with 26 healthy women who had undergone prophylactic mastectomy of both (bilateral) breasts (BPM), 45 women who had undergone prophylactic mastectomy of one breast (unilateral contralateral) (UPM) after diagnosis of invasive breast cancer in the other breast or ductal carcinoma in situ (DCIS), and 37 women who were considering having PM surgery. Results: Of the women who had undergone PM, more than half felt pre-surgical psychological consultation was advisable; nearly 2/3 thought post-surgical psychological consultation would be helpful. All women currently considering PM believed psychological consultation would aid decision-making and preparation for surgery. Strong support was reported in all groups for the emotional and informational value of speaking with a woman who had previously undergone PM. Conclusions: Narratives illustrate the nature and intensity of the need for psychological support and describe preferences for the role of the psychologist. Suggestions are offered for integration of psychological services for women deciding about or adapting to PM.

Original languageEnglish (US)
Pages (from-to)831-843
Number of pages13
JournalPsycho-Oncology
Volume17
Issue number8
DOIs
StatePublished - Aug 2008
Externally publishedYes

Fingerprint

Referral and Consultation
Psychology
surgery
cancer
decision making
Decision Making
Breast
Prophylactic Mastectomy
Breast Neoplasms
Carcinoma, Intraductal, Noninfiltrating
Risk Reduction Behavior
North America
qualitative interview
cross-sectional study
psychologist
speaking
coping
Cross-Sectional Studies
acceptance
Interviews

Keywords

  • Cancer
  • Oncology
  • Outcomes
  • Prophylactic mastectomy
  • Psychological service delivery

ASJC Scopus subject areas

  • Oncology
  • Psychology(all)
  • Social Sciences (miscellaneous)

Cite this

Support needs and acceptability of psychological and peer consultation : Attitudes of 108 women who had undergone or were considering prophylactic mastectomy. / Patenaude, Andrea F.; Orozco, Sara; Li, Xiaochun; Kaelin, Carolyn M.; Gadd, Michelle; Matory, Yvedt; Mayzel, Kathleen; Roche, Constance A.; Smith, Barbara L.; Farkas, Walden; Garber, Judy E.

In: Psycho-Oncology, Vol. 17, No. 8, 08.2008, p. 831-843.

Research output: Contribution to journalArticle

Patenaude, AF, Orozco, S, Li, X, Kaelin, CM, Gadd, M, Matory, Y, Mayzel, K, Roche, CA, Smith, BL, Farkas, W & Garber, JE 2008, 'Support needs and acceptability of psychological and peer consultation: Attitudes of 108 women who had undergone or were considering prophylactic mastectomy', Psycho-Oncology, vol. 17, no. 8, pp. 831-843. https://doi.org/10.1002/pon.1279
Patenaude, Andrea F. ; Orozco, Sara ; Li, Xiaochun ; Kaelin, Carolyn M. ; Gadd, Michelle ; Matory, Yvedt ; Mayzel, Kathleen ; Roche, Constance A. ; Smith, Barbara L. ; Farkas, Walden ; Garber, Judy E. / Support needs and acceptability of psychological and peer consultation : Attitudes of 108 women who had undergone or were considering prophylactic mastectomy. In: Psycho-Oncology. 2008 ; Vol. 17, No. 8. pp. 831-843.
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abstract = "Objective: Prophylactic mastectomy (PM) offers 90{\%} or greater reduction in risk of breast cancer to women at increased hereditary risk. Nonetheless, acceptance in North America is low (0-27{\%}) and 25-50{\%} of women electing surgery report psychological distress and/or difficulty adapting following PM. Most women also report reduced cancer worry postoperatively. Psychological consultation to aid decision-making and post-surgical coping is not routinely offered. This retrospective, cross-sectional study explored interest in and acceptability of psychological consultation for issues related to PM among 108 women who had undergone or were considering surgery. Method: Qualitative interviews were conducted with 26 healthy women who had undergone prophylactic mastectomy of both (bilateral) breasts (BPM), 45 women who had undergone prophylactic mastectomy of one breast (unilateral contralateral) (UPM) after diagnosis of invasive breast cancer in the other breast or ductal carcinoma in situ (DCIS), and 37 women who were considering having PM surgery. Results: Of the women who had undergone PM, more than half felt pre-surgical psychological consultation was advisable; nearly 2/3 thought post-surgical psychological consultation would be helpful. All women currently considering PM believed psychological consultation would aid decision-making and preparation for surgery. Strong support was reported in all groups for the emotional and informational value of speaking with a woman who had previously undergone PM. Conclusions: Narratives illustrate the nature and intensity of the need for psychological support and describe preferences for the role of the psychologist. Suggestions are offered for integration of psychological services for women deciding about or adapting to PM.",
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AU - Li, Xiaochun

AU - Kaelin, Carolyn M.

AU - Gadd, Michelle

AU - Matory, Yvedt

AU - Mayzel, Kathleen

AU - Roche, Constance A.

AU - Smith, Barbara L.

AU - Farkas, Walden

AU - Garber, Judy E.

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N2 - Objective: Prophylactic mastectomy (PM) offers 90% or greater reduction in risk of breast cancer to women at increased hereditary risk. Nonetheless, acceptance in North America is low (0-27%) and 25-50% of women electing surgery report psychological distress and/or difficulty adapting following PM. Most women also report reduced cancer worry postoperatively. Psychological consultation to aid decision-making and post-surgical coping is not routinely offered. This retrospective, cross-sectional study explored interest in and acceptability of psychological consultation for issues related to PM among 108 women who had undergone or were considering surgery. Method: Qualitative interviews were conducted with 26 healthy women who had undergone prophylactic mastectomy of both (bilateral) breasts (BPM), 45 women who had undergone prophylactic mastectomy of one breast (unilateral contralateral) (UPM) after diagnosis of invasive breast cancer in the other breast or ductal carcinoma in situ (DCIS), and 37 women who were considering having PM surgery. Results: Of the women who had undergone PM, more than half felt pre-surgical psychological consultation was advisable; nearly 2/3 thought post-surgical psychological consultation would be helpful. All women currently considering PM believed psychological consultation would aid decision-making and preparation for surgery. Strong support was reported in all groups for the emotional and informational value of speaking with a woman who had previously undergone PM. Conclusions: Narratives illustrate the nature and intensity of the need for psychological support and describe preferences for the role of the psychologist. Suggestions are offered for integration of psychological services for women deciding about or adapting to PM.

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