Optimising the delivery of breast cancer risk estimates to women aged 30-39 years: women’s views


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Session type:

Sarah Bellhouse1, Louise Gorman1, Sacha Howell1, Rhiannon Hawkes1, David French1, N/a N/a2, N/a N/a2, N/a N/a2, N/a N/a2, N/a N/a2, N/a N/a2, N/a N/a2, N/a N/a2, N/a N/a2, N/a N/a2, N/a N/a2, N/a N/a2, N/a N/a2, N/a N/a2, N/a N/a2, N/a N/a2, N/a N/a2, N/a N/a2, N/a N/a2, N/a N/a2, N/a N/a2
1University of Manchester, 2Other

Abstract

Background

Identifying women aged 30-39 years at increased risk of breast cancer could allow them to receive the benefits of enhanced screening and preventative strategies, such as risk-reducing medication. However, it is unclear how best to communicate breast cancer risk estimates to these women, to avoid potential harms such as undue anxiety whilst increasing potential benefits such as informed decision-making. This qualitative study aimed to investigate women’s views on the optimal delivery of a breast cancer risk assessment service.

Method

Women aged 30-39 years with no family history or personal experience of breast cancer (total n=37) took part in seven focus groups (k=2 face-to-face and k=5 online; n=29 women, including n=5 from ethnic minority backgrounds) and eight semi-structured interviews (three face-to-face and five telephone). Participants were recruited via advertisements on social media and in community settings. Data were audio-recorded and analysed thematically using a framework approach to data organisation.

Results

Participants favoured a ‘one-stop shop’ delivery model whereby all components of the risk assessment are completed at a single appointment. Availability of appointments outside of normal working hours and ability to book a convenient appointment were considered essential requirements of the service. Many participants expressed a preference for the service to be delivered on a mobile unit based in local community settings such as workplace and supermarket car parks. Participants expected a high risk result to be communicated face-to-face or via phone whereas a letter was considered acceptable for low risk. Irrespective of risk level, access to an individual with appropriate expertise and information about what would happen next were considered paramount.

Conclusion

A flexible and locally available service should be offered to promote successful engagement of young women in breast cancer risk assessment. Risk feedback ought to focus on outlining next steps for management to mitigate any potential distress the risk result may cause. Informed by these insights, a feasibility trial of breast cancer risk prediction in this population is being set up.

Impact statement

Our research identifies key requirements of a novel breast cancer risk assessment service from the perspectives of those eligible to attend and will shape future implementation research.