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Background: For omen ith unilateral breast cancer, a surgical option is the removal of the cancer-free breast contralateral prophylactic mastectomy, CPM . CPM among omen ith unilateral breast cancer is increasing despite the lack of evidence that it improves overall survival. There are limited data regarding factors associated ith the decision to have CPM hich limits the development of interventions to support informed decision-making. Methods: We recruited 343 omen ith nely diagnosed non-hereditary breast cancer prior to their first surgical consultation beteen 2012 and 2015. Women completed questionnaires assessing knoledge and level of interest in different surgical procedures including CPM, individuals ith hom they discussed CPM and psychosocial factors. Results: The mean age of the participants as 56 years range 25-82 and 48 omen 14 percent had CPM. Women ere 57 percent hite, 17 percent African American, 16 percent Hispanic, 10 percent other races. In univariate analyses, discussion of CPM ith the medical oncologist p = 0.03 and a strong interest in having mastectomy for the primary breast cancer p lt 0.001 ere associated ith CPM but discussion ith the primary care provider p = 0.63 , spouses p = 0.62 or breast cancer survivors p = 0.45 as not associated ith CPM. Women ho had more breast cancer orry p lt 0.001 , more intrusive thoughts about recurrence p = 0.05 , and more distress about body image p = 0.003 ere more likely to have CPM. In multivariable analysis, age OR [odds ratio] 0.95, 95 percent CI [confidence interval] 0.91-0.99, p = 0.036 for every year increase in age , strong versus lo interest in having mastectomy for the primary breast cancer OR 12.16, 95 percent CI 1.53 -96.4, p = 0.02 and breast cancer orry OR 1.17, 95 percent CI 1.10-1.36, p = 0.03 for every unit increase remained significantly associated ith CPM. Conclusions: Because of the important role that medical oncologists play in the decision making process of CPM, education regarding CPM should be focused on these providers in addition to surgeons. Addressing cancer orry among breast cancer patients is an area for intervention ith decision support tools and counseling to ensure only patients most likely to derive clinical or psychosocial benefits ill receive CPM.,J Clin Oncol 34, 2016 suppl; abstr 6581 00:00.0,Health Services Research and Quality of Care

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