Pondering Prophylactic Mastectomy: Social Relations of Medical Technology in the Genomic Age

Bilateral prophylactic mastectomy (BPM) is a preventive option for women at high risk of familial breast cancer, entailing the removal of both the left and right breast. Despite an absence of randomised controlled trials (level I and II evidence), it appears that BPM is being undertaken at dissimilar rates across countries; France is resisting the procedure, regarding it is a radical if not totally undesirable option, yet America provides such treatment on demand (Eisinger et al. 1999). A research project is proposed to investigate this treatment rationale in Australia. Via in-depth interviews with up to twelve women (18-40 years old) with a family history of breast cancer and up to six breast oncologists and surgeons, the decision-making landscape will be explored across both personal and professional domains. Focauldian and Beckian frameworks will inform subsequent thematic analysis. In tandem, the validity of lived experience versus that of evidence-based medicine will be explored. Introducing prophylactic mastectomy ‘…from a public health point of view, the impact of any treatment depends not only on efficacy, but also on availability, affordability, an