Abstract：
UNASSIGNED: Observe patient-clinician communication to gain insight about the reasons underlying the choice of patients with unilateral breast cancer to undergo contralateral prophylactic mastectomy (CPM), despite lack of survival benefit, risk of harms, and cautions expressed by surgical guidelines and clinicians.
UNASSIGNED: WORDS is a prospective study that explored patient-clinician communication and patient decision making. Participants recorded clinical visits through a downloadable mobile application. We analyzed 44 recordings from 22 patients: 9 who chose CPM, 8 who considered CPM but decided against it, and 5 who never considered CPM. We used abductive analysis combined with constructivist grounded theory methods.
UNASSIGNED: Decisions to undergo CPM are patient-driven and motivated by perceptions that CPM is the most aggressive, and therefore safest, treatment option available. These decisions are shaped not primarily by the content of conversations with clinicians, but by the history of cancer in patients\' families, their own first-hand experiences with cancers among loved ones, fear for their children, and anxiety about cancer recurrence.
UNASSIGNED: The perception that CPM is the safest, most aggressive option strongly influences patients, despite scientific evidence to the contrary. Future efforts to address high CPM rates should focus on patient-driven decision making and cancer-related fears.
UNASSIGNED: WORDS is a prospective study that explored patient-clinician communication and patient decision making. Participants recorded clinical visits through a downloadable mobile application. We analyzed 44 recordings from 22 patients: 9 who chose CPM, 8 who considered CPM but decided against it, and 5 who never considered CPM. We used abductive analysis combined with constructivist grounded theory methods.
UNASSIGNED: Decisions to undergo CPM are patient-driven and motivated by perceptions that CPM is the most aggressive, and therefore safest, treatment option available. These decisions are shaped not primarily by the content of conversations with clinicians, but by the history of cancer in patients\' families, their own first-hand experiences with cancers among loved ones, fear for their children, and anxiety about cancer recurrence.
UNASSIGNED: The perception that CPM is the safest, most aggressive option strongly influences patients, despite scientific evidence to the contrary. Future efforts to address high CPM rates should focus on patient-driven decision making and cancer-related fears.
摘要：
■观察患者与临床医生的沟通，以了解选择单侧乳腺癌患者进行对侧预防性乳房切除术（CPM）的根本原因，尽管缺乏生存益处，危害的风险，以及手术指南和临床医生表达的注意事项。
■WORDS是一项前瞻性研究，旨在探索患者与临床医生的沟通和患者的决策。参与者通过可下载的移动应用程序记录临床访问。我们分析了22名患者的44条记录：9名选择CPM的患者，8人考虑了CPM，但决定反对，和5个从未考虑过CPM的人。我们使用归纳法分析结合建构主义扎根理论方法。
■接受CPM的决定是由患者驱动的，并且被认为CPM是最积极的，因此最安全,治疗方案可用。这些决定主要不是由与临床医生对话的内容决定的，但根据患者家族的癌症史,他们在亲人中与癌症的第一手经验，害怕他们的孩子，和对癌症复发的焦虑。
■认为CPM是最安全的，最具侵略性的选择会强烈影响患者，尽管科学证据相反。解决高CPM率的未来努力应集中在患者驱动的决策和与癌症相关的恐惧上。
■WORDS是一项前瞻性研究，旨在探索患者与临床医生的沟通和患者的决策。参与者通过可下载的移动应用程序记录临床访问。我们分析了22名患者的44条记录：9名选择CPM的患者，8人考虑了CPM，但决定反对，和5个从未考虑过CPM的人。我们使用归纳法分析结合建构主义扎根理论方法。
■接受CPM的决定是由患者驱动的，并且被认为CPM是最积极的，因此最安全,治疗方案可用。这些决定主要不是由与临床医生对话的内容决定的，但根据患者家族的癌症史,他们在亲人中与癌症的第一手经验，害怕他们的孩子，和对癌症复发的焦虑。
■认为CPM是最安全的，最具侵略性的选择会强烈影响患者，尽管科学证据相反。解决高CPM率的未来努力应集中在患者驱动的决策和与癌症相关的恐惧上。
