Contralateral prophylactic mastectomy use has increased over the past decades among women with early-stage breast cancer. Racial differences in contralateral prophylactic mastectomy use are well described, but with unclear causes. This study examined contralateral prophylactic mastectomy use among black and white women and the contribution of differences in perceived risk to differences in use. We surveyed women diagnosed with early-stage unilateral breast cancer between ages 41–64 in Pennsylvania and Florida between 2007–2009 to collect data on breast cancer treatment, family history, education, income, insurance, and perceived risk. Clinical factors—age,stage at diagnosis, receptor status—were obtained from cancer registries. The relationships between patient factors and contralateral prophylactic mastectomy were assessed using logistic regression. The interaction between race and contralateral prophylactic mastectomy on the perceived risk of second breast cancers was tested using linear regression. Of 2182 study participants, 18% of whites underwent contralateral prophylactic mastectomy compared with 10% of blacks (p < 0.001). The racial difference remained after adjustment for clinical factors and family history (odds ratio = 2.32, 95% confidence interval 1.76–3.06, p < 0.001). The association between contralateral prophylactic mastectomy and a reduction in the perceived risk of second breast cancers was significantly smaller for blacks than whites. Blacks were less likely than whites to undergo contralateral prophylactic mastectomy even after adjustment for clinical factors. This racial difference in use may relate to the smaller impact of contralateral prophylactic mastectomy on the perceived risk of second breast cancers among blacks than among whites. Future research is needed to understand the overall impact of perceived risk on decisions about contralateral prophylactic mastectomy and how that may explain racial differences in use.

在过去的几十年中，早期乳腺癌患者中对侧预防性乳房切除术的使用有所增加。对侧预防性乳房切除术使用中的种族差异已得到充分描述，但原因尚不清楚。这项研究检查了黑人和白人妇女的对侧预防性乳房切除术的使用以及感知风险差异对使用差异的影响。我们调查了2007-2009年在宾夕法尼亚州和佛罗里达州被诊断患有早期单侧乳腺癌的女性，年龄在41-64岁之间，以收集有关乳腺癌治疗，家族史，教育，收入，保险和感知风险的数据。临床因素-年龄，诊断分期，受体状态-从癌症登记处获得。使用逻辑回归分析评估患者因素与对侧预防性乳房切除术之间的关系。使用线性回归测试种族和对侧预防性乳房切除术对第二种乳腺癌的感知风险之间的相互作用。在2182名研究参与者中，有18％的白人接受了对侧预防性乳房切除术，而黑人有10％（p  <0.001）。调整临床因素和家族史后，种族差异仍然存在（优势比= 2.32，95％置信区间1.76–3.06，p <0.001）。对侧预防性乳房切除术与降低第二发乳腺癌风险之间的关联，黑人比白人小得多。即使在调整了临床因素之后，黑人也不如白人进行对侧预防性乳房切除术。使用中的种族差异可能与对侧预防性乳房切除术对黑人相比白人对第二种乳腺癌的感知风险的影响较小有关。需要进一步的研究来了解感知风险对对侧预防性乳房切除术的决定的总体影响，以及如何解释使用中的种族差异。