Assessing and managing breast cancer risk: Clinicians' current practice and future needs

Citation

Collins I, Steel E, Mann GB, Emery J, Bickerstaffe A, Trainer A, Butow P, Pirotta M, Antoniou AC, Cuzick J, Hopper JL, Phillips K & Keogh L (2014) Assessing and managing breast cancer risk: Clinicians' current practice and future needs. The Breast, 23 (5), pp. 644-650. https://doi.org/10.1016/j.breast.2014.06.014

Abstract
Decision support tools for the assessment and management of breast cancer risk may improve uptake of prevention strategies. End-user input in the design of such tools is critical to increase clinical use. Before developing such a computerized tool, we examined clinicians' practice and future needs. Twelve breast surgeons, 12 primary care physicians and 5 practice nurses participated in 4 focus groups. These were recorded, coded, and analyzed to identify key themes. Participants identified difficulties assessing risk, including a lack of available tools to standardize practice. Most expressed confidence identifying women at potentially high risk, but not moderate risk. Participants felt a tool could especially reassure young women at average risk. Desirable features included: evidence-based, accessible (e.g. web-based), and displaying absolute (not relative) risks in multiple formats. The potential to create anxiety was a concern. Development of future tools should address these issues to optimize translation of knowledge into clinical practice.

Keywords
Breast cancer; BRCA; Risk reduction; Clinical decision support; Needs assessment

Journal
The Breast: Volume 23, Issue 5