Contralateral Prophylactic Mastectomy (CPM) and the clinical consultation: A snapshot of UK healthcare professionals’ views and experiences

Abstract

Increasing numbers of women are undergoing Contralateral Prophylactic Mastectomy (CPM) in the UK. However, professional guidelines suggest CPM does not offer oncological benefit to the majority of women with breast cancer. Whilst research has explored women's motivations for seeking CPM, this study aimed to address a gap in the literature by investigating healthcare professionals' (HCPs) experiences and attitudes of caring for women considering CPM. HCPs involved in the care of women considering CPM were invited to complete an online survey concerning: the process and management of decision-making, their attitudes towards CPM provision and challenges they faced in CPM provision. Fifty-eight HCPs completed the survey. Respondents felt that perceived future breast cancer risk was women's most common motivation for CPM. Fifty-four percent of respondents agreed patients should be offered the choice of CPM for risk reduction if they are at increased clinical risk. Fifty-one percent agreed patients should be offered the choice of CPM as a means of achieving symmetry, and 19% agreed that women should be offered CPM for reasons related to risk-reduction, if they were not thought to be at an increased clinical risk. Patients' understanding of risks versus benefits was seen as the greatest challenge facing HCPs. Many respondents were hesitant to explore CPM with all patients in their care, reflecting current service restrictions and their own beliefs around CPM. These findings highlight the need for exploration of patient's perspectives on this process and a review of care provision and information available related to CPM.