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Breast. 2014 Jul 3. pii: S0960-9776(14)00127-1. doi: 10.1016/j.breast.2014.06.014. [Epub ahead of print]

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

Author information

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

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.

Copyright © 2014. Published by Elsevier Ltd.

KEYWORDS:

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

PMID:
24998452
[PubMed - as supplied by publisher]
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