{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T22:21:24Z","timestamp":1768256484876,"version":"3.49.0"},"reference-count":69,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Med Humanities"],"accepted":{"date-parts":[[2022,11,16]]},"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:p>Contralateral prophylactic mastectomy (CPM) is a controversial breast cancer treatment in which both breasts are removed when only one is affected by cancer. Rates of CPM have been rising since the late 1990s, despite surgeons\u2019 strong agreement that the procedure should not be performed for average-risk women. This essay analyses that agreement as it is demonstrated in the surgical literature on CPM, arguing that it forms a \u2018rhetoric of certainty\u2019 built on the stark epistemological divide between objective and subjective forms of knowledge that operates in some areas of medicine. Further, the essay argues that this rhetoric of certainty has the potential to function as a kind of eristic rhetoric in which the right conclusion is known prior to any rhetorical exchange. As a way to \u2018crack open\u2019 this certainty, the essay compares the rhetoric of the surgical literature on CPM to the rhetoric of uncertainty in the radiological literature on breast cancer screening for women with a personal history of the disease. The goal of this comparison is not to suggest surgeons should support all choices for CPM. Rather, the aim is to demonstrate that choices against the procedure are not as straightforward as the surgical literature indicates and that the uncertainty affecting women\u2019s preferences for CPM is not solely the result of patient misunderstanding and\/or emotional instability.<\/jats:p>","DOI":"10.1136\/medhum-2022-012460","type":"journal-article","created":{"date-parts":[[2022,12,22]],"date-time":"2022-12-22T10:05:21Z","timestamp":1671703521000},"page":"378-389","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Cracking open the eristic rhetoric of contralateral prophylactic mastectomy research or why surgeons should not be so certain about this controversial breast cancer treatment"],"prefix":"10.1136","volume":"49","author":[{"given":"Kelly","family":"Pender","sequence":"first","affiliation":[{"name":"English, Virginia Tech, Blacksburg, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,12,22]]},"reference":[{"issue":"6","key":"2025092412401326000_49.3.378.1","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.breast.2016.04.005","article-title":"\u201cContralateral Prophylactic Mastectomy (CPM): A Systematic Review of Patient Reported Factors and Psychological Predictors Influencing Choice and Satisfaction.\u201d","volume":"28","author":"Ager","year":"2016","journal-title":"The Breast"},{"key":"2025092412401326000_49.3.378.2","unstructured":"American Cancer Society . n.d \u201cAmerican Cancer Society Recommendations for the Early Detection of Breast Cancer.\u201d https:\/\/www.cancer.org\/cancer\/breast-cancer\/screening-tests-and-early-detection\/american-cancer-society-recommendation-for-the-early-detection-of-breast-cancer.html."},{"key":"2025092412401326000_49.3.378.3","unstructured":"American College of Radiology . 2013. \u201cACR BI-RADS ATLAS-Breast MRI.\u201d https:\/\/www.acr.org\/-\/media\/ACR\/Files\/RADS\/BI-RADS\/MRI-Reporting.pdf."},{"issue":"10","key":"2025092412401326000_49.3.378.4","doi-asserted-by":"crossref","first-page":"3208","DOI":"10.1245\/s10434-015-4758-y","article-title":"\u201cContralateral Prophylactic Mastectomy: Challenging Considerations for the Surgeon.\u201d","volume":"22","author":"Angelos","year":"2015","journal-title":"Annals of Surgical Oncology"},{"key":"2025092412401326000_49.3.378.5","unstructured":"Aristotle . 1991. 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