Abstract
BackgroundBreast cancer is the most common cancer in the UK. Lifestyle factors including excess weight contribute to risk of developing the disease. Whilst the exact links between weight and breast cancer are still emerging, it is imperative to explore how women understand these links and if these beliefs impact on successful behaviour change.MethodOverweight/obese premenopausal women (aged 35–45) with a family history of breast cancer (lifetime risk 17–40%) were invited to a semi-structured interview following their participation in a 12 month weight loss intervention aimed at reducing their risk of breast cancer. Interviews were carried out with 9 women who successfully achieved ≥5% weight loss and 11 who were unsuccessful. Data were transcribed verbatim and analysed using thematic analysis.ResultsThree themes were developed from the analysis. The first theme how women construct and understand links between weight and breast cancer risk is composed of two subthemes, the construction of weight and breast cancer risk and making sense of weight and breast cancer risk. This theme explores women’s understanding of what contributes to breast cancer risk and whether they believe that weight loss could reduce their breast cancer risk. The second theme motivation and adherence to weight loss interventions explains that breast cancer risk can be a motivating factor for adherence to a weight loss intervention. The final theme, acceptance of personal responsibility for health is composed of two subthemes responsibility for one’s own health and responsibility for family health through making sensible lifestyle choices.ConclusionBeliefs about weight and breast cancer risk were informed by social networks, media reports and personal experiences of significant others diagnosed with breast cancer. Our study has highlighted common doubts, anxieties and questions and the importance of providing a credible rationale for weight control and weight loss which addresses individual concerns. Counselling and health education material should be tailored to facilitate understanding of both genetic and modifiable risk factors and should do more help individuals to visualise the weight and breast cancer link.
Highlights
Breast cancer is the most common cancer in the UK with 49,564 women newly diagnosed in 2010 [1]
Beliefs about weight and breast cancer risk were informed by social networks, media reports and personal experiences of significant others diagnosed with breast cancer
Participants received intensive one to one counselling on the links between weight and risk from doctors and a research dietitian in a specialist Family History Clinic (FHC). Despite this advice their understanding of factors they consider to be influential to their cancer risk were largely informed by social networks, media reports and personal experiences of significant others diagnosed with breast cancer, indicating that for many women specialist counselling does not override these deeply held beliefs
Summary
Breast cancer is the most common cancer in the UK with 49,564 women newly diagnosed in 2010 [1]. A combination of reproductive factors, family history, and lifestyle factors including excess weight has a significant impact on the risk of developing the disease [2]. Expert reports recommend the prevention of weight gain and maintenance of a healthy weight to reduce the risk of breast cancer and other diseases [2,5,6]. Intervention trials report reduced levels of breast cancer related hormones with modest weight loss (5-10%) in both pre- and postmenopausal women, including reductions in oestradiol, inflammatory markers, and change in adipokines [11]. Whilst the exact links between weight and breast cancer are still emerging, it is imperative to explore how women understand these links and if these beliefs impact on successful behaviour change
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