Breast Cancer Prevention: The Views of Women and Physicians

Grant #: Research Grant
PI Name: Kaplan C
Title: Breast Cancer Prevention: The Views of Women and Physicians
Institute: California Breast Cancer Research Fund

Breast cancer is one of the leading women's health concerns in the United States, where over 180,000 new cases are diagnosed each year. Recent research has led not only to a better understanding of surgical and chemotherapeutic treatment, but also on how lifestyle and genetic predisposition are related to the risk of breast cancer.

Despite such advances, the medical community has been unable to establish clear-cut guidelines for women to assess their breast cancer risk, and there is a lack of consensus as to the most appropriate and effective ways to reduce this risk. Given the relative lack of breast cancer prevention guidelines and controversy within the field, physicians potentially have a very key role in (and great responsibility for) providing risk assessment and risk reduction information to their patients.

An appropriate message from physicians about breast cancer prevention could positively impact patients' attitudes, motivations, and behavior. However, more needs to be known about how doctors currently advise their patients about breast cancer risk, and about the factors affecting these practices.

This study proposes to help fill this gap by examining the self-reported knowledge, attitudes and practices of women and physicians with regard to breast cancer prevention. The investigators will conduct a telephone survey of 1200 women, from four ethnic groups, at varying risk of breast cancer. Participants will be recruited from the San Francisco Mammography Registry (SFMR), a population-based mammography registry (est. 1994) that collects breast health information, mammogram results, and cancer status from all mammography facilities in San Francisco. Women will be eligible if they are between 40 and 75 years of age, have no prior history of breast cancer, and are English, Spanish, or Cantonese speaking. The specific aims of the survey are to: examine women's perceived risk for breast cancer and their knowledge of factors that may reduce breast cancer risk, the means by which risk is typically assessed, and the source of this information; and, to understand factors that would lead a woman to undertake primary prevention actions. The investigators will also examine the differences in knowledge and practice by these women.

In addition, a randomized survey of 1000 physicians from three different specialties (general internal medicine, family medicine, and obstetrics/gynecology) practicing in the Bay Area will be performed. This survey will examine physician knowledge of breast cancer prevention and beliefs about the effectiveness of current therapies, as well as current practices, attitudes, and perceived obstacles to breast cancer prevention. The investigators will also determine if there are any differences among physicians based on the type of practice and gender of physician.

The growing therapeutic options for the primary prevention of breast cancer, and the direct advertising of new therapies to women make this an opportune time to study how women assess their risk of breast cancer, acquire information about new therapies and make decisions about their use. Knowledge gained from this study will facilitate the development and evaluation of physicians' and patients' interventions targeted to improve patient-doctor decision-making with respect to breast cancer prevention. The ultimate goal is to ensure that all women, regardless of their ethnic/racial group, receive from their doctors the most up-to-date and reliable medical information available so that they may make informed choices regarding their health.