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Decision-making experiences of breast cancer patients related to contralateral prophylactic mastectomy—a systematic meta-synthesis of qualitative studies

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Abstract

Purpose

Currently, the choice of contralateral prophylactic mastectomy (CPM) for breast cancer patients is variable and controversial. Breast cancer patients must make complex and rapid decisions based on the benefits and risks of CPM. Although there are many qualitative studies on the decision-making experiences of breast cancer patients, there is a lack of synthesis of these qualitative studies. Our study goals were to conduct a meta-synthesis of qualitative studies on the decision-making experiences, real-life experiences, psychological feelings and needs of breast cancer patients in CPM decision-making, with the aim of providing information to support the development of CPM practice decisions.

Methods

Using a meta-ethnographic approach, qualitative research studies were analysed and synthesised using the method of “reciprocal translational analysis”, and themes related to the decision-making experiences of breast cancer patients with respect to CPM were identified.

Results

Five hundred ninety-three documents were retrieved. This meta-synthesis ultimately collected 8 studies. Four themes were identified: (1) decision motivations for survival and body intention; (2) negative and vacillating decision emotions; (3) diverse but weak decision support; (4) short-term satisfaction but long-term unknown and differentiated decision effects.

Conclusions

We found that although patients had different feelings about the effects of CPM in detail, most patients were satisfied with the short-term effects of CPM, but the long-term effects of CPM were still unknown.

The study protocol was registered with PROSPERO (International prospective register of systematic reviews) in May 2022 (Registration number: CRD42022334260).

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Data Availability

Data available on request from the authors.

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Acknowledgements

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Authors and Affiliations

  1. Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Weiqi Road, Jinan, 250021, Shandong Province, China

    Baosheng Zhao, Hong Lyu, Xiaoman Zhang, Yujie Liu & Xinhong Song

  2. School of Nursing and Rehabilitation, Shandong University, No. 44 Wenhuaxi Road, Jinan, 250012, Shandong Province, China

    Mo Yi

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  1. Baosheng Zhao
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  2. Mo Yi
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Contributions

Baosheng Zhao was responsible for designing the study, retrieving the data, interpreting the data and drafting the text. Mo Yi was responsible for retrieving the data and interpreting the data. Hong Lv was responsible for retrieving the data and interpreting the data. XiaoMan Zhang was responsible for interpreting the data. Yujie Liu was responsible for interpreting the data. Xinhong Song was responsible for designing the study, critical review of the intellectual content of the article, support and guidance. All authors reviewed the manuscript.

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Correspondence to Xinhong Song.

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Zhao, B., Yi, M., Lyu, H. et al. Decision-making experiences of breast cancer patients related to contralateral prophylactic mastectomy—a systematic meta-synthesis of qualitative studies. Support Care Cancer 31, 214 (2023). https://doi.org/10.1007/s00520-023-07674-x

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