Transformational learning and self-efficacy: an investigation into their role in prophylactic mastectomy

Breast cancer affects one in eight women in the United States. Estimated new
breast cancer cases for 2012 in the U.S. are 229,060 women (American Cancer Society, 2012). For all women it is important to be informed regarding all current treatment options. For women in high-risk categories of breast cancer it is even more important. Risk-reducing strategies for women at high-risk of breast cancer include surveillance, chemoprevention, and bilateral prophylactic mastectomy. Prophylactic mastectomy reduces the risk of breast cancer by excision of most breast tissue. Breast cancer among those initially diagnosed as high-risk is 90-94.3% (Hartmann et al., 1999). This procedure entails serious surgeries with numerous physical, social, and emotional ramifications and is not without side effects. The patient has the right to be informed and base her decision-making on the suitability of the procedure for herself. This research describes six (6) woman’s experiences, focusing on the role of transformational learning and self-efficacy, as these women progressed through the stages. Prophylactic mastectomy is radical, irreversible, and costly at the onset. The procedure may preclude a whole lifetime of surgeries, radiation, and chemical treatments. If this treatment is the right fit, and has been fully researched, balanced with options, family history, genetic predisposition, personal concerns, and anxiety levels, along with physician recommendations, a woman should consider pursuing it.