Abstract
• The median lower lifetime breast cancer risk threshold at which clinicians found women eligible for bilateral prophylactic mastectomy (BPM) was 40 % (IQR 30 %–50 %). • Key factors that influence BPM decisions were: germline pathogenic variants, family history, and age (77 %), woman's preference (74 %), and reducing the breast cancer life time risk (58 %). • Lifestyle factors such as smoking and alcohol consumption (44 %) also played a role. The most important quality of life considerations were: easing cancer worries (45 %) and impact on quality of life (49 %). • Eighty percent of the clinicians agreed that a more comprehensive guideline should be established regarding the indication for BPM.