Main Article Content
Contralateral prophylactic mastectomy (CPM) is the removal of both breasts when one is affected by cancer. Researchers and journalists typically attribute increased use of this controversial procedure to patient misunderstanding of breast cancer risk. Thus, efforts to curb CPM use focus on better patient education. I argue that such efforts are potentially ineffective insofar as they fail to recognize that risk isn’t just something that patients know but also something that they do, and that how they do it affects their healthcare decisions. I further argue that this failure can lead to impaired communication about CPM by perpetuating sexist stereotypes of women as too emotional to make good decisions. To improve communication, then, I draw on screening guidelines and public discourse about CPM to show how patients do breast cancer risk, arguing that they often experience a kind of overtreatment that makes CPM an effective, if unconventional, treatment choice.
ACR BI-RADS Atlas—Breast MRI. (n.d.). Retrieved from http://www.acr.org/-/media/ACR/
Angelos, P., Bedrosian, I., Euhus, D., Herrmann, V., Katz, S., & Pusic, A. (2015). Contralateral
prophylactic mastectomy: Challenging considerations for the surgeon. Annals of Surgical
Oncology, 22, 3208-3212.
Baptiste, D., MacGeorge, E., Venetis, A., Mouton, A., Friley, L., Pastor, R., & Bowling, M.
(2017). Motivations for contralateral prophylactic mastectomy as a function of
socioeconomic status. BMC Women’s Health, 17, 1-9.
Benson, J.R. & Winters, Z.E. (2016). Contralateral prophylactic mastectomy. British Journal of
Surgery, 103, 1249-1250.
Boughey, J., Attai, D., Chen, S., Hiram, C., Dietz, J., Feldman, S., . . . Margenthaler, J. (2016).
Contralateral prophylactic mastectomy consensus statement from the American Society
of Breast Surgeons: Additional considerations and a framework for shared decision
making. Annals of Surgical Oncology, 23, 3106-3111.
Covelli, A., Baxter, N., Fitch, M., McCready, D., & Wright, F. (2015). ‘Taking control of
cancer’: Understanding women’s choice for mastectomy. Annals of Surgical Oncology
Graham, S. (2015). The Politics of Pain Medicine: A Rhetorical-Ontological Inquiry. Chicago:
University of Chicago Press.
Guth, U., Myrick, M.E., Viehl, C.T., Weber, W.P., Lardi, & Schmid, S.M. (2011). Increasing
rates of contralateral prophylactic mastectomy—A trend made in the USA? European
Journal of Surgical Oncology, 38, 296-301.
Han, E., Johnson, N., Glissmeyer, M., Wagie, T., Carey, B., DelaMelena, T., & Nelson, J. (2011).
Increasing incidence of bilateral mastectomies: The patient perspective. The American
Journal of Surgery, 201, 615-618.
Houssami, N., & Cho, N. (2018). Screening women with a personal history of breast cancer:
Overview of the evidence on breast imaging surveillance. Ultrasonography, 37.4, 277-287.
Kaplan, K. (2016, December 21). 17% of Women with Early-Stage Breast Cancer Have
Unnecessary Mastectomies, and Doctors Want to Know Why. Los Angeles Times.
Retrieved from http://www.latimes.com
McGinley, L. (2016, March 7). More Women with Cancer in One Breast Are Having Double
Mastectomies. That Might Not Be a Good Thing. The Washington Post. Retrieved from
Mol, A. & Law, J. (2004). Embodied action, enacted bodies: The example of hypoglycemia.
Body and Society, 10, 43-62.
Monticciolo, D., Newell, M.S., Moy, L., Niell, B., Monsees, B., & Sickles, E.A. (2018). Breast
cancer screening in women at higher-than-average risk: Recommendations from the
ACR. Journal of American College of Radiology, 15, 408-414.
Nass, S., & Nekhlyudov, L. (2017). Commentary on the consensus statement of the American
Society of Breast Surgeons on contralateral prophylactic mastectomy. Annals of Surgical
Oncology, 24, 611-613.
Newman, L. (2014). Contralateral prophylactic mastectomy: Is it a reasonable option? JAMA,
Orenstein, P. (2014, July 26). The wrong approach to breast cancer. New York Times. Retrieved
Plevritis, S., Kurian, A., Sigal, B., Daniel, B., Ikeda, D., Stockdale, F., & Garber, A. (2006). Cost-
effectiveness of screening BRCA 1/2 mutation carriers with breast magnetic resonance
imaging. JAMA, 295, 2374-2384.
Pope Parker, T. (2010, March 8). After cancer, removing a healthy breast. New York Times.
Retrieved from http://www.nytimes.com
Rabin, R. (2016, March 21). No regrets after double mastectomy, but questions remain. New York
Times. Retrieved from http://www.nytimes.com
Rabin, R. (2017, March 29). More women opt to remove healthy breast. New York Times.
Retrieved from http://www.nytimes.com
Raikhlin, A., Curpen, B., Warner, E., Betel, C., Wright, B., & Jong, R. (2015). Breast MRI as an
adjunct to mammography for breast cancer screening in high-risk patients: Retrospective
review. American Journal of Roentgenology, 204, 889-897.
Saslow, D., Boetes, C., Burke, W., Harms, S., Leach, M.O., Lehman, C.D., . . . & Russell, C.A.
(2007). American Cancer Society guidelines for breast screening with MRI as an adjunct
to mammography. CA: A Cancer Journal for Clinicians, 57.2, 75-89.
Tuttle, T., Habermann, E., Grund, E., Morris, T., Virnig, B. (2007). Increasing use of
contralateral prophylactic mastectomy for breast cancer patients: A trend toward more
aggressive surgical treatment. Journal of Clinical Oncology, 25, 5203-5209.