Women?s Regrets After Bilateral Prophylactic Mastectomy

Payne, David; Biggs, Carina; Tran, Katherine N.; Borgen, Patrick I.; Massie, Mary Jane

doi:10.1007/s10434-000-0150-6

Cited by 89 publications

(59 citation statements)

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Section: These Studies Base Their Analysis On the Linear-in-parametermentioning

confidence: 99%

“…Ziarnowski et al (2009) found that anticipated regret played an important role in the decision to vaccinate adolescent girls against HPV. Furthermore, several studies highlighted that regret can be experienced by patients before or after cancer-related decisions (e.g., Hu et al, 2003, Montgomery et al, 1999, Clark et al 2001, 2003, Payne et al 2000, and Joseph-Williams et al, 2010.2 The idea that regret is an important determinant of choice behaviour is not new and is well established theoretically and empirically in many fields, including marketing (e.g. Simonson, 1992;Zeelenberg and Pieters, 2007), microeconomics (e.g.…”

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confidence: 99%

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The role of regret minimisation in lifestyle choices affecting the risk of coronary heart disease

Boeri

Longo

Grisolía

et al. 2013

Journal of Health Economics

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Research Highlights: This paper introduces the discrete choice paradigm of Random Regret Minimization (RRM) to the field of health economics The combined use of RRM and Random Utility Maximization (RUM) models provide useful behavioural insights on choice Whilst the RUM is suitable for calculating welfare estimates, the RRM highlights how anticipated regret affects choices We find that the choices of overweight or obese respondents and smokers are more likely to conform to the RUM approach We also find that the choices of people in good health and with higher education are more likely to reflect the RRM approach AbstractPage 2 of 31 A c c e p t e d M a n u s c r i p t This paper introduces the discrete choice model-paradigm of Random Regret Minimization (RRM) to the field of health economics. The RRM is a regret-based model that explores a driver of choice different from the traditional utility-based Random Utility Maximization (RUM). The RRM approach is based on the idea that, when choosing, individuals aim to minimize their regret -regret being defined as what one experiences when a non-chosen alternative in a choice set performs better than a chosen one in relation to one or more attributes. Analysing data from a discrete choice experiment on diet, physical activity and risk of a fatal heart attack in the next ten years administered to a sample of the Northern Ireland population, we find that the combined use of RUM and RRM models offer additional information, providing useful behavioural insights for better informed policy appraisal.Keywords: Random Regret Minimization; Random Utility Maximization; dietary choices; physical activity; coronary heart disease risk; behavioural economics. Page 3 of 31A c c e p t e d M a n u s c r i p t IntroductionDiscrete choice experiments (DCE) are a survey-based technique used to investigate the trade-offs that people are prepared to make between different hypothetical goods or services, where respondents are shown alternative variants of the good or service described by a set of attributes and are asked to choose the most preferred one (Ryan and Hughes, 1997;Vick and Scott, 1998). Since the first applications of DCE in health economics to value patient experiences (Ryan and Hughes, 1997;Ryan, 1999), this technique has become widely used to investigate a wide range of policy questions (Ryan et al., 2008 Evidence from previous studies suggests that regret can be an important factor in both medical decision making (Smith, 1996;Djulbegovic et al. 1999 andSorum et al. 2004) and personal healthcare decisions (Brehaut et al., 2003 andZiarnowski et al., 2009), particularly when the outcome of the choice may be unfavourable. Smith (1996) explored the concept of regret in healthcare decision making from the patient's viewpoint, arguing that valuation techniques based on the utility theory, such as QALYs, will not necessarily reflect the true preferences of the individual. Ziarnowski et al. (2009) found that anticipated regret played an important role in the decision to vaccinate adol...

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Section: These Studies Base Their Analysis On the Linear-in-parametermentioning

confidence: 99%

mentioning

confidence: 99%

The role of regret minimisation in lifestyle choices affecting the risk of coronary heart disease

Boeri

Longo

Grisolía

et al. 2013

Journal of Health Economics

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“…Studies have shown that up to half of women who undergo RRM report a negative impact on their sexual relationship [11,12,10], a quarter to one-third report poorer body image and reduced feelings of femininity [12,10], and women are more likely to report feelings of regret related to their surgery when body image and sexual function are adversely affected by RRM [13]. Despite this, few women who undergo RRM report that they regret their surgery decision [14,15,12].…”

Section: Introductionmentioning

confidence: 99%

Long-term outcomes of risk-reducing surgery in unaffected women at increased familial risk of breast and/or ovarian cancer

et al. 2014

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Purpose: To prospectively investigate long-term psychosocial outcomes for women who opted for risk-reducing mastectomy (RRM) and/or risk-reducing salpingo-oophorectomy (RRSO).Methods: Unaffected women from high-risk breast cancer families who had completed baseline questionnaires for an existing study and subsequently underwent RRM and/or RRSO, completed measures of perceived breast and ovarian cancer risk, anxiety, depression, cancer-related anxiety, body image, sexual functioning, menopausal symptoms, use of hormone replacement therapy and decision regret three years post-surgery. Outcomes were compared to age-and risk-matched controls.Results: Participants (N=233) were 17 women who had RRM (39 controls), 38 women who had RRSO (94 controls) and 15 women who had RRM+RRSO (30 controls). Women who underwent RRM and those who underwent RRM+RRSO reported reductions in perceived breast cancer risk and perceived breast and ovarian cancer risk respectively, compared to their respective controls. RRM women reported greater reductions in cancer-related anxiety compared with both controls and RRSO women. RRSO women reported more sexual discomfort than controls and more urogenital menopausal symptoms than controls and RRM only women. No differences in general anxiety, depression or body image were observed. Regret was associated with greater reductions in body image since surgery and more sexual discomfort, although overall regret levels were low. Conclusions:Women who undergo RRM experience psychological benefits associated with reduced breast cancer risk. Although women who undergo RRSO experience some deterioration in sexual and menopausal symptoms, they do not regret their surgery decision. It is vital that women considering these procedures receive detailed information about potential psychosocial consequences.3

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“…However, an important predictor of a patient later regretting having had PM is when the physician was the one to introduce this option into the discussion of treatment [6,45]. This emphasizes that physicians must be well aware of how much they may influence a woman's decision to have prophylactic surgery, and they must remain alert when giving advice about possible treatment and monitoring options and verify whether the choice for prophylactic surgery is based on the patients' own decision.…”

Section: Screening For Cancermentioning

confidence: 99%

Predictors of choosing life-long screening or prophylactic surgery in women at high and moderate risk for breast and ovarian cancer

2008

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The aim of this study is to summarize published empirical data describing the predictors of adhering to screening practices and choosing to have prophylactic surgery in women at increased risk for breast and ovarian cancer. Pubmed, Psychinfo and Cinahl databases were searched to identify studies on the predictors of adherence to breast and ovarian cancer screening and predictors of having a prophylactic mastectomy or salpingo-oophorectomy. We found 37 empirical studies that met our inclusion criteria. The main predictors of the use of preventive measures are related to DNA test results, socio-demographic characteristics, and psychological outcome measures. It is concluded that there is no unequivocal relationship between age, education, risk perception, or anxiety and adherence to breast and ovarian cancer screening practices. Worrying about cancer is associated with a higher adherence to screening practices.

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Women?s Regrets After Bilateral Prophylactic Mastectomy

Cited by 89 publications

References 10 publications

The role of regret minimisation in lifestyle choices affecting the risk of coronary heart disease

The role of regret minimisation in lifestyle choices affecting the risk of coronary heart disease

Long-term outcomes of risk-reducing surgery in unaffected women at increased familial risk of breast and/or ovarian cancer

Predictors of choosing life-long screening or prophylactic surgery in women at high and moderate risk for breast and ovarian cancer

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