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

Ian M Collins; Emma Steel; G Bruce Mann; Jon D Emery; Adrian Bickerstaffe; Alison Trainer; Phyllis Butow; Marie Pirotta; Antonis C Antoniou; Jack Cuzick; John Hopper; Kelly-Anne Phillips; Louise A Keogh

doi:10.1016/j.breast.2014.06.014

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

Breast. 2014 Oct;23(5):644-50. doi: 10.1016/j.breast.2014.06.014. Epub 2014 Jul 4.

Authors

Affiliations

¹ Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia.
² Academic Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Australia.
³ Royal Women's Hospital, Melbourne, Australia.
⁴ Dept. of General Practice and Primary Care Academic Centre, University of Melbourne, Australia; School of Primary, Aboriginal and Rural Health Care, University of Western Australia, Perth, Australia.
⁵ Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Australia.
⁶ Sir Peter MacCallum Dept. of Oncology, The University of Melbourne, Australia.
⁷ Centre for Medical Psychology & Evidence-based Decision-making (CeMPED), University of Sydney, Sydney, Australia.
⁸ Dept. of General Practice and Primary Care Academic Centre, University of Melbourne, Australia.
⁹ Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
¹⁰ Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, UK.
¹¹ Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Australia; Sir Peter MacCallum Dept. of Oncology, The University of Melbourne, Australia; Dept. of Medicine, St Vincent's Hospital, The University of Melbourne, Australia.
¹² Academic Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Australia. Electronic address: l.keogh@unimelb.edu.au.

PMID: 24998452
DOI: 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: BRCA; Breast cancer; Clinical decision support; Needs assessment; Risk reduction.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Aged, 80 and over
Attitude of Health Personnel*
Breast Neoplasms* / diagnosis
Breast Neoplasms* / therapy
Decision Support Systems, Clinical*
Female
Focus Groups
Humans
Male
Middle Aged
Needs Assessment*
Practice Patterns, Nurses'*
Practice Patterns, Physicians'*
Qualitative Research
Risk Assessment
Victoria

Abstract

Publication types

MeSH terms

Grants and funding