Perceived Breast Cancer Risk Research Articles

Using an Internet-Based Breast Cancer Risk Assessment Tool to Improve Social-Cognitive Precursors of Physical Activity.

Internet-based cancer risk assessment tools might serve as a strategy for translating epidemiological risk prediction research into public health practice. Understanding how such tools affect key social-cognitive precursors of behavior change is crucial for leveraging their potential into effective interventions. To test the effects of a publicly available, Internet-based, breast cancer risk assessment tool on social-cognitive precursors of physical activity. Women (N = 132) aged 40-78 with no personal cancer history indicated their perceived risk of breast cancer and were randomly assigned to receive personalized ( www.yourdiseaserisk.wustl.edu ) or nonpersonalized breast cancer risk information. Immediately thereafter, breast cancer risk perceptions and physical activity-related behavioral intentions, self-efficacy, and response efficacy were assessed. Personalized information elicited higher intentions, self-efficacy, and response efficacy than nonpersonalized information, P values < 0.05. Self-efficacy and response efficacy mediated the effect of personalizing information on intentions. Women who received personalized information corrected their inaccurate risk perceptions to some extent, P values < 0.05, but few fully accepted the information. Internet-based risk assessment tools can produce beneficial effects on important social-cognitive precursors of behavior change, but lingering skepticism, possibly due to defensive processing, needs to be addressed before the effects can be maximized.

Investigating young women\u2019s motivations to engage in early mammography screening in Switzerland: results of a cross-sectional study

BackgroundThe scientific and public debate concerning organized mammography screening is unprecedentedly strong. With research evidence concerning its efficacy being ambiguous, the recommendations pertaining to the age-thresholds for program inclusion vary between – and even within – countries. Data shows that young women who are not yet eligible for systematic screening, have opportunistic mammograms relatively often and, moreover, want to be included in organized programs. Yet, to date, little is known about the precise motivations underlying young women’s desire and intentions to go for, not medically indicated, mammographic screening.MethodsA cross-sectional online survey was carried out among women aged 30-49 years (n = 918) from Switzerland.ResultsThe findings show that high fear (β = .08, p ≤ .05), perceived susceptibility (β = .10, p ≤ .05), and ego-involvement (β = .34, p ≤ .001) are the main predictors of screening intentions among women who are not yet eligible for the systematic program. Also, geographical location (Swiss-French group: β = .15, p ≤ .001; Swiss-Italian group: β = .26, p ≤ .001) and age (β = .11, p ≤ .001) play a role. In turn, breast cancer knowledge, risk perceptions, and educational status do not have a significant impact.ConclusionsYoung women seem to differ inherently from those who are already eligible for systematic screening in terms of the factors underlying their intentions to engage in mammographic screening. Thus, when striving to promote adherence to systematic screening guidelines – whether based on unequivocal scientific evidence or policy decisions – and to allow women to make evidence-based, informed decisions about mammography, differential strategies are needed to reach different age-groups.

Communicating breast cancer risk information to young adult women: A pilot study

ABSTRACTObjective: To examine the effectiveness of a health promotion flyer to increase awareness of breast cancer risk and physical activity as a risk reduction strategy in young adult women. Methods: Young adult women (N = 123) viewed one of five health promotion flyers online and then completed measures of perceived breast cancer risk (PR) and perceived informativeness (PI) and a qualitative thought-listing activity. Results: Differences were observed in PI such that the control and low risk/low information messages were significantly less informative than the others. Qualitative analyses revealed two general themes: message content and flyer design. Additional analyses of the flyer design comments revealed four sub-themes: negative thoughts about the image, positive thoughts about the image, misunderstanding breast cancer risk information, and social comparison. Exploratory analyses controlling for message type indicated that image appraisal predicted PI such that those who commented on the image found the flyer to be less informative. Discussion: Results suggest that the flyer was informative but did not impact young women's breast cancer risk perceptions. Additionally, the image may have distracted young women from the intended message. Evaluating the acceptability of images used in health promotion materials is recommended before testing the effectiveness of the intervention.

A Survey of Osteoporosis and Breast Cancer Risk Perception among Menopausal and Postmenopausal Women in Hong Kong.

ObjectivesA lack of understanding in menopausal and postmenopausal women's (PMW) risk perception towards osteoporosis and breast cancer still exists, which is explored in this study. This information might allow health professionals to conduct interventions to improve health behaviors before menopause-related diseases are imminent.MethodsBetween 10 December 2015 and 31 January 2016, 573 menopausal or PMW were successfully interviewed on 17 questions, comprising separate sections for osteoporosis and breast cancer. The target respondents were menopausal or PMW aged 45 to 60 years, with no previous diagnosis of osteoporosis or breast cancer, who attended private clinics across Hong Kong for annual physical examination.ResultsRegarding menopausal issues, the top three concerns were osteoporosis and fracture (72%), breast cancer (44%), and sleep disorder/insomnia/headache (40%). Among 314 respondents (55%) who tried to prevent osteoporosis, 74% of them began to do it after they were 40 years old. On the other hand, 65% of respondents never had a bone density test. For respondents who said “I'm too young, so I don't need to check”, their mean age was 52 years old. Ninety percent of respondents mistakenly believed that regular breast examination, regular breast massage, drink soy milk, or vaccine can prevent breast cancer.ConclusionsThis survey revealed osteoporosis and breast cancer as the top concerns among menopausal and PMW in Hong Kong. Inadequate health behaviors and misconceptions still exist despite widespread health education in the recent years.

Population-Based Study of Attitudes toward BRCA Genetic Testing among Orthodox Jewish Women.

Given the high prevalence (1 in 40) of BRCA1 and BRCA2 mutations among Ashkenazi Jews, population-based BRCA genetic testing in this ethnic subgroup may detect more mutation carriers. We conducted a cross-sectional survey among Orthodox Jewish women in New York City to assess breast cancer risk, genetic testing knowledge, self-efficacy, perceived breast cancer risk and worry, religious and cultural factors affecting medical decision-making. We used descriptive statistics and multivariable logistic regression models to identify predictors of genetic testing intention/uptake. Among evaluable respondents (n = 243, 53% response rate), median age was 25 and nearly half (43%) had a family history of breast cancer. Only 49% of the women had adequate genetic testing knowledge and 46% had accurate breast cancer risk perceptions. Five percent had already undergone BRCA genetic testing, 20% stated that they probably/definitely will get tested, 28% stated that they probably/definitely will not get tested, and 46% had not thought about it. High decision self-efficacy, adequate genetic testing knowledge, higher breast cancer risk, and overestimation of risk were associated with genetic testing intention/uptake. Decision support tools that improve knowledge and self-efficacy about genetic testing may facilitate population-based BRCA testing among Orthodox Jews.

Health literacy and the perception of risk in a breast cancer family history clinic

BackgroundInformed consent is an essential component of medical practice, and especially so in procedural based specialties which entail varying degrees of risk. Breast cancer is one of the most common cancers in women, and as such is the focus of extensive research and significant media attention. Despite this, considerable misperception exists regarding the risk of developing breast cancer. AimsThis study aims to examine the accuracy of risk perception of women attending a breast cancer family history clinic, and to explore the relationship between risk perception accuracy and health literacy. MethodsA cross-sectional study of women attending a breast cancer family history clinic (n = 86) was carried out, consisting of a patient survey and a validated health literacy assessment. Patients’ perception of personal and population breast cancer risk was compared to actual risk as calculated by a validated risk assessment tool. ResultsSignificant discordance between real and perceived risks was observed. The majority (83.7%) of women overestimated their personal lifetime risk of developing breast cancer, as well as that of other women of the same age (89.5%). Health literacy was considered potentially inadequate in 37.2% of patients; there was a correlation between low health literacy and increased risk perception inaccuracy across both personal ten-year (rs = 0.224, p = 0.039) and general ten-year population estimations. (rs = 0.267, p = 0.013). ConclusionInaccuracy in risk perception is highly prevalent in women attending a breast cancer family history clinic. Health literacy inadequacy is significantly associated with this inaccuracy.

Predictors of Breast Cancer Worry in a Hispanic and Predominantly Immigrant Mammography Screening Population

ObjectiveWorry about developing breast cancer (BC) has been associated with participation in screening and genetic testing and with follow-up of abnormal screening results. Little is known about the scope and predictors of BC worry in Hispanic and immigrant populations. MethodsWe collected in-person interview data from 250 self-identified Hispanic women recruited from an urban mammography facility (average age 50.4 years; 82% foreign-born). Women reported whether they worried about developing breast cancer rarely/never (low worry), sometimes (moderate worry), or often/all the time (high worry). We examined whether sociocultural and psychological factors (e.g., acculturation, education, perceived risk), and risk factors and objective risk for BC (e.g., family history, Gail model 5-year risk estimates, parity) predicted BC worry using multinomial and logistic regression. ResultsIn multivariable models, women who perceived higher absolute BC risk (odds ratio, 1.66 [95% confidence interval, 1.28–2.14] for a one-unit increase in perceived lifetime risk) and comparative BC risk (e.g., odds ratio, 2.73, 95% confidence interval, 1.23–6.06) were more likely to report high BC worry than moderate or low BC worry. There were no associations between BC worry and indicators of objective risk or acculturation. ConclusionsIn Hispanic women undergoing screening mammography, higher perceptions of BC risk, in both absolute and comparative terms, were associated independently with high BC worry, and were stronger predictors of BC worry than indicators of objective BC risk, including family history, mammographic density, and personal BC risk estimates.

Mixed method systematic review: the relationship between breast cancer risk perception and health-protective behaviour in women with family history of breast cancer.

The aim of this study was to determine and explore the relationship between risk perception and health-protective behaviour in individuals with family history of breast cancer. Women with increased risk of breast cancer due to inherited predisposition can use health-protective behaviours to facilitate prevention or early detection of cancer. Four scientific literature databases (CINAHL, Medline, AMED, PsychInfo) and three systematic review databases were searched. Mixed method systematic review. The systematic review of peer-reviewed literature was conducted following the method described by the Centre of Reviews and Dissemination. Research studies published in English between January 2004-December 2014 focussing on individuals with family history of breast cancer were included. Of 210 papers identified, 10 studies were eligible for inclusion. Studies were assessed for their quality. Due to the diversity of the studies, a three-step analysis was undertaken involving narrative summary of the quantitative data, thematic analysis and presentation of integrated results in narrative form. A clear link between breast cancer risk perception and some health-protective behaviour was identified. Screening administered by health professionals (mammogram screening, chemoprevention) were appropriately adopted. However, behaviours requiring high individual input (breast self-examination, lifestyle changes) were not as appropriately adopted and the decision process was not as clearly linked to risk perception. There is limited understanding about the complex relationship between risk perception and health-protective behaviour. Risk communication and health promotion need to be further developed to assist individuals to better engage with their actual risk and risk-appropriate behaviours, particularly those that require regular personal effort.

Influences of race and breast density on related cognitive and emotion outcomes before mandated breast density notification

RationaleMany states have adopted laws mandating breast density (BD) notification for applicable women; however, very little is known about what women knew or felt about BD and related breast cancer (BC) risk before implementation of BD notification laws. ObjectiveWe examined between-race differences in the extent to which having dense breasts was associated with women's related BD cognition and emotion, and with health care providers' communication about BD. MethodsWe received surveys between May and October of 2015 assessing health care provider (HCP) communication about BD, BD-related knowledge, BD-related anxiety and BC worry from 182 African American (AA) and 113 European American (EA) women in the state of Michigan for whom we had radiologists' assessments of BD. ResultsWhereas having dense breasts was not associated with any BD-related cognition or emotion, there were robust effects of race as follows: EA women were more likely to have been told about BD by a HCP, more likely to know their BD status, had greater knowledge of BD and of BC risk, and had greater perceptions of BC risk and worry; AA women had greater BD-related anxieties. EA women's greater knowledge of their own BD status was directly related to the increased likelihood of HCP communication about BD. However, HCP communication about BD attenuated anxiety for AA women only. ConclusionWe present the only data of which we are aware that examines between-race differences in the associations between actual BD, HCP communication and BD related cognition and emotion before the implementation of BD notification laws. Our findings suggest that the BD notification laws could yield positive benefits for disparities in BD-related knowledge and anxiety when the notifications are followed by discussions with health care providers.

N06 - The role of factors affecting worry and risk perception of breast cancer in a chemoprevention trial of tamoxifen

N06 - The role of factors affecting worry and risk perception of breast cancer in a chemoprevention trial of tamoxifen

Breast Cancer Knowledge and Preventive Behavior Among Filipino Women in a Rural Area: A Cross-Sectional Study

Background: The incidence and mortality rates of breast cancer are high among Filipino women. The lack of knowledge on preventive behavior and early detection related to breast cancer is considered a reason. Objectives: This study aimed to determine the association between knowledge about breast cancer and selected sociodemographic characteristics, daily life factors, reproductive factors, and perceived breast cancer risk factors. Patients and Methods: This study used a cross-sectional design. The study population consisted of 527 women. Interviews were conducted by the investigators. The contents of the questionnaire collected basic characteristics of the respondents, including their sociodemographic profiles, their knowledge of breast cancer risk factors, preventive behaviors, early detection, and their daily life and reproductive factors. Predictor variables were analyzed using a Chi-square test, Fisher’s exact test, and a t-test. Multivariate logistic regression was applied for any significant differences (P < 0.005) among the predictor variables. One-way ANOVA and Tukey’s HDS were used to evaluate the association between education level and reproductive factors. Results: Less than half of the women (42.7%) had knowledge on breast cancer risk factors, and an equivalent number had knowledge on breast cancer symptoms. Women with higher educational levels were noted to give birth to their first child at a significantly older age and have a significantly lower number of childbirths. Multivariate logistic regression demonstrated that body mass index, education history, knowledge about symptoms, knowing how to conduct a breast self-examination, family history of cancer, and passive smoking could predict breast cancer knowledge. Conclusions: Women who were aware of risk factors for breast cancer possessed a higher education level and had knowledge of the association of risk factors with preventive behaviors and early detection. However, a minority of women (42.7%) knew enough about breast cancer, preventive behaviors, and what actions to take for early detection.

Factors modulating worry and risk perception of breast cancer in a prevention trial of low dose tamoxifen in postmenopausal hormone users.

e13048Background: We previously showed that refusal to participate in a breast cancer prevention trial was associated with higher worry about breast cancer. Given this counterintuitive finding, we ...

Effects of a risk-based online mammography intervention on accuracy of perceived risk and mammography intentions

ObjectiveThis experiment tested the effects of an individualized risk-based online mammography decision intervention. The intervention employs exemplification theory and the Elaboration Likelihood Model of persuasion to improve the match between breast cancer risk and mammography intentions. Methods2918 women ages 35–49 were stratified into two levels of 10-year breast cancer risk (<1.5%; ≥1.5%) then randomly assigned to one of eight conditions: two comparison conditions and six risk-based intervention conditions that varied according to a 2 (amount of content: brief vs. extended) x 3 (format: expository vs. untailored exemplar [example case] vs. tailored exemplar) design. Outcomes included mammography intentions and accuracy of perceived breast cancer risk. ResultsRisk-based intervention conditions improved the match between objective risk estimates and perceived risk, especially for high-numeracy women with a 10-year breast cancer risk ≤1.5%. For women with a risk≤1.5%, exemplars improved accuracy of perceived risk and all risk-based interventions increased intentions to wait until age 50 to screen. ConclusionA risk-based mammography intervention improved accuracy of perceived risk and the match between objective risk estimates and mammography intentions. Practice implicationsInterventions could be applied in online or clinical settings to help women understand risk and make mammography decisions.

Breast cancer risk feedback to women in the UK NHS breast screening population.

Introduction:There are widespread moves to develop risk-stratified approaches to population-based breast screening. The public needs to favour receiving breast cancer risk information, which ideally should produce no detrimental effects. This study investigates risk perception, the proportion wishing to know their 10-year risk and whether subsequent screening attendance is affected.Methods:Fifty thousand women attending the NHS Breast Screening Programme completed a risk assessment questionnaire. Ten-year breast cancer risks were estimated using a validated algorithm (Tyrer-Cuzick) adjusted for visually assessed mammographic density. Women at high risk (⩾8%) and low risk (<1%) were invited for face-to-face or telephone risk feedback and counselling.Results:Of those invited to receive risk feedback, more high-risk women, 500 out of 673 (74.3%), opted to receive a consultation than low-risk women, 106 out of 193 (54.9%) (P<0.001). Women at high risk were significantly more likely to perceive their risk as high (P<0.001) and to attend their subsequent mammogram (94.4%) compared with low-risk women (84.2% P=0.04) and all attendees (84.3% ⩽0.0001).Conclusions:Population-based assessment of breast cancer risk is feasible. The majority of women wished to receive risk information. Perception of general population breast cancer risk is poor. There were no apparent adverse effects on screening attendance for high-risk women whose subsequent screening attendance was increased.

Adherence to the breast cancer surveillance program for women at risk for familial breast and ovarian cancer versus overscreening: a monocenter study in Germany.

Breast cancer (BC) is the leading cancer among women worldwide and in 5-10% of cases is of hereditary origin, mainly due to BRCA1/2 mutations. Therefore, the German Consortium for Familial Breast and Ovarian Cancer (HBOC) with its 15 specialized academic centers offers families at high risk for familial/hereditary cancer a multimodal breast cancer surveillance program (MBCS) with regular breast MRI, mammography, ultrasound, and palpation. So far, we know a lot about the psychological effects of genetic testing, but we know little about risk-correlated adherence to MBCS or prophylactic surgery over time. The aim of this study was to investigate counselees' adherence to recommendations for MBCS in order to adjust the care supply and define predictors for incompliance. All counselees, who attended HBOC consultation at the University Hospital Heidelberg between July 01, 2009 and July 01, 2011 were eligible to participate. A tripartite questionnaire containing sociodemographic information, psychological parameters, behavioral questions, and medical data collection from the German consortium were used. A high participation rate was achieved among the study population, with 72% returning the questionnaire. This study showed a rate of 59% of full-adherers to the MBCS. Significant predictors for partial or full adherence were having children (p=0.0221), younger daughters (p=0.01795), a higher awareness of the topic HBOC (p=0.01795, p<0.0001), a higher perceived breast cancer risk (p<0.0001), and worries (p=0.0008)/impairment (p=0.0257) by it. Although the current data suggest a good adherence of MBCS, prospective studies are needed to understand counselees' needs to further improve surveillance programs and adherence to them. Adherence to the breast cancer surveillance program for women at risk for familial breast and ovarian cancer versus overscreening-a monocenter study in Germany.

Abstract B54: Concordance between objective and perceived breast cancer risk and breast cancer worry in racially diverse and immigrant women

Abstract Appropriate risk-based screening and risk-reducing interventions are important breast cancer (BC) prevention strategies. However, evidence suggests that many women inaccurately perceive their risk of BC, and that inaccurate perceptions of BC may be associated with inappropriately high or low levels of breast cancer worry, an important factor for health preventive behavior and psychological well-being. We used concordance between objective and perceived BC risk to measure accuracy of risk perception and examined whether accurate perceived risk was associated with BC worry in a predominantly racial minority (66% Hispanic, 16% black), and immigrant (63% foreign-born) sample of women (n=366, aged 40-64 years). We collected in-person interview data on perceived BC risk using the question, “Compared to the average woman your age, would you say that you are more likely to get breast cancer, less likely, or about as likely?”, and measured BC worry using the question “How often do you worry about getting breast cancer?”, with response options ranging from rarely or never to all the time. Objective risk was assessed through calculating 5-year risk estimates from the Gail model. Using the clinical threshold of ≥ 1.67%, 11% of the sample were categorized as high-risk (hereafter clinical high-risk). We also compared women's personal 5-year risk score to that of the 5-year risk score produced by the Gail model for an average women of the same age as participants, and categorized 23% of the sample as high-risk if personal risk score was ≥0.25 greater than the average women's risk score (hereafter comparative high-risk). Women whose risk scores did not meet the above thresholds were considered average-risk. We used binary and ordinal logistic regression to examine the association of concordance of perceived and objective risk with socioedemographic factors and BC worry. The majority of women (81%) correctly perceived their risk, with the proportion of correct risk perception higher in average-risk women (87%) than in high-risk women (36%). Accurate risk perception (i.e., concordance between perceived and objective risk) was lowest in women who were U.S.-born, English-speakers, had higher health literacy and were non-Hispanic white (e.g., 55% of whites vs. 88% and 78% in Hispanic and African American women respectively had correct risk perceptions relative to clinical risk). Women with family history of BC were also more likely to have inaccurate perceived risk (57% vs. 85%). Compared to average-risk women with low perceived risk, women who perceive their BC risk to be high, regardless of their objective risk, had higher BC worry while women with low perceived risk but high objective risk had lower BC worry. After adjusting for race/ethnicity, language acculturation, education and family history, average-risk women who perceived themselves to be at higher risk continued to have statistically significantly higher odds of BC worry (OR=3.00, 95% CI:1.60-5.62 for clinical risk, and OR=3.96, 95% CI: 1.96-7.98 for comparative risk, both relative to average-risk women with low perceived risk). In conclusion, while the majority of women correctly perceived their risk for breast cancer, a substantial proportion of high-risk women inaccurately perceived themselves to be at average risk and/or lower risk than average women of the same age. High perceived risk predicted higher BC worry in both average- and high-risk women. Increasing women's knowledge of their breast cancer risk may improve inaccurate risk perception and inappropriate BC worry, and help women better appraise their risk management options. Citation Format: Ayana K. April-Sanders, Parisa Tehranifar. Concordance between objective and perceived breast cancer risk and breast cancer worry in racially diverse and immigrant women. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr B54.

Psychological Outcomes After a False Positive Mammogram: Preliminary Evidence for Ethnic Differences Across Time.

Adverse psychological consequences of screening mammography are well-documented for women who receive a false positive result. However, little is known about ethnic differences. To address this gap, we examine distress associated with an abnormal mammogram (results-related distress) and perceived lifetime risk of breast cancer (perceived risk) among Latinas and non-Latina White (NLW) women 3months after receipt of a false positive result. A sample of 28 Latina and 27 NLW women who received an initial abnormal mammogram result and later, a definitive non-cancer diagnosis were recruited for this descriptive, longitudinal study. Women were interviewed twice: within 30days and 3months after a false positive result. Questionnaires included standard sociodemographic questions, the Impact of Events Scale-Revised, and two perceived breast cancer risk items. All participants experienced decreased distress 3months after the initial results. Latinas experienced higher levels of distress, F(1,45)=4.58, p=0.04, and had a significant increase in perceived breast cancer risk over time, F(1,45)=3.99, p=0.05. Larger population-based studies are necessary to confirm ethnic differences in mental health consequences of false positive results. Given cultural emphases concerning respect for authority figures, healthcare professionals may be particularly helpful in working with Latinas to mitigate distress and clarify accurate perceptions of breast cancer risk through evidence-based practice.

Abstract P2-09-23: Factors associated with BRCA genetic testing intention and uptake among Orthodox Jewish women

Abstract Background: Ashkenazi Jews have a 1 in 40 prevalence of carrying a BRCA1/2 mutation, mainly due to 3 founder mutations. Prior literature suggests that population-based genetic testing among Ashkenazi Jews is cost-effective and may detect over 50% more mutation carriers than family history-based screening. Orthodox Jewish women are an understudied population with unique social, cultural, and religious factors that may influence BRCA genetic testing. The aim of our study was to examine factors associated with BRCA genetic testing intention/uptake among the Orthodox Jewish community. Methods: A one-time online survey was distributed to Orthodox Jewish women by 3 shuls from Washington Heights, NY (53% response rate) and through additional referrals. The questionnaire obtained information regarding demographics, breast cancer risk factors, genetic testing knowledge, decision self-efficacy, perceived breast cancer risk, breast cancer worry, and religious and cultural factors affecting medical decision-making. The Tyrer-Cuzick model was used to calculate lifetime breast cancer risk and accurate risk perception was defined as within +/-10% of actual lifetime risk. Descriptive statistics and multivariable logistic regression models were used to identify independent predictors of genetic testing intention/uptake. Results: Among 342 evaluable participants, median age was 26 years (range, 19-77); 92% were Ashkenazi and 8% Ashkenazi/Sephardi; 98% had a college education, including 47% with post-graduate degrees. Despite being highly educated, only 54% of women had adequate genetic testing knowledge. Median lifetime breast cancer risk was 16% (range, 2.3-60.9) and only 44% had accurate breast cancer risk perceptions. Although 48% had a family history of breast cancer and 16% had a relative that tested positive for BRCA1/2 mutation, only 5% had undergone BRCA testing while 48% had the intention of undergoing genetic testing. Higher lifetime breast cancer risk, high decision self-efficacy regarding genetic testing, overestimation of breast cancer risk, and increased breast cancer worry were associated with genetic testing intention/uptake. The most important factors in the decision to have BRCA testing were to help prevent dying of cancer (55%), to help prevent getting cancer (54%), and effect on children (40%). Multivariable analysis of factors associated with BRCA genetic testing intention/uptake OR95% CIp-valueDecision Self-Efficacy (range, 0 [not confident] - 4 [very confident])1.41.02-1.980.038Actual Lifetime Breast Cancer Risk (range, 0 - 100%)1.11.03-1.100.0005Accuracy in Breast Cancer Risk Perception Accurate (referent)1.0--Underestimate1.20.50-2.850.691Overestimate2.61.45-4.610.001Breast Cancer Worry (range, 1 [none] - 7 [worry all of the time])1.51.18-1.980.001 Conclusions: By understanding the religious and cultural issues regarding genetic testing in the Orthodox Jewish community, we can develop targeted interventions designed to enhance decision self-efficacy and improve accuracy of breast cancer risk perceptions to decrease unnecessary worry. This may in turn increase informed decision-making about BRCA genetic testing and implementation of cancer prevention strategies among Ashkenazi Jews. Citation Format: Trivedi MS, Tang EY, Kukufka R, Chung WK, David R, Respler L, Leifer S, Schechter I, Crew KD. Factors associated with BRCA genetic testing intention and uptake among Orthodox Jewish women. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-09-23.

Abstract P6-10-01: Results from NRG oncology/NSABP protocol DMP-1: Women's decision-making in breast cancer risk reduction

Abstract Background: Tamoxifen and raloxifene are two selective receptor modulators (SERMs) that have been shown to reduce the risk of developing breast cancer in women at increased risk of the disease. Both drugs are infrequently used in the general U.S. population. Increased knowledge about the risks and benefits of SERM use for breast cancer risk reduction does not lead to increased uptake of chemoprevention. We know little about what influences decision-making regarding breast cancer risk reduction with SERMs. Methods: To better understand what influences SERM decision-making for breast cancer risk reduction we conducted a survey study assessing social, environmental, and psychological factors that may influence a woman's decision. Women who talked to a health care provider (HCP) about SERM use (N=1,023) received a questionnaire immediately after the HCP visit that asked about the counseling session, sociodemographics, experiences with breast cancer, breast cancer risk, and risk perception. After its completion a second survey was administered that inquired about issues surrounding medication intake such as attitudes about taking medicines in general, trust in pharmaceutical companies, and in their HCP. A statistical comparison of survey responses was performed between those who decided to take a SERM and those who decided not to take a SERM. Logistic regression was used to determine a key set of independent factors associated with the decision. Results: Of the 1,023 women, 716 made a decision about SERM intake (70%) and were included in the study. Of those, 324 (45%) decided to take a SERM and 392 (55%) decided not to take a SERM. Of SERM users 89.8% received a recommendation to take a SERM by the HCP compared to 44.4% of non-users. Only 15.7% of SERM users reported never having had a breast biopsy compared to 26.3% of non-users. Overall, SERM users had a higher breast cancer risk, risk perception, and worry about getting breast cancer. In multivariate analysis 11 factors were identified as having independent association with SERM use, including: recommendation from HCP, attitudes and perceptions regarding medication intake, influenced by someone's breast cancer diagnosis, breast cancer worry, trust in HCP, a diagnosis of atypical hyperplasia, and others' experiences with SERM intake. Women who had one or more first degree relatives with breast cancer were less likely to take a SERM. Neither breast cancer risk nor risk perception influenced SERM decision-making. Discussion: Factors that influence SERM decision-making are related to women's personal experiences with breast cancer, their HCP, and attitudes towards medications. Conclusions: Social, environmental, and psychological factors proved to be more important for SERM decision-making than breast cancer risk or risk perception. In addition to presenting risks and benefits in counseling, the importance of personal experiences and attitudes for decision-making need to be considered to understand and support women's decision-making on SERM use for breast cancer risk reduction. SUPPORT: U10CA37377, -69974; -180868, -180822; -189867. Citation Format: Holmberg C, Bandos H, Fagerlin A, Bevers TB, Battaglia TA, Wickerham DL, McCaskill-Stevens W. Results from NRG oncology/NSABP protocol DMP-1: Women's decision-making in breast cancer risk reduction. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P6-10-01.

Abstract P3-10-03: Receipt of breast cancer risk assessment and personalized prevention information among women diagnosed with a benign breast lesion (BBL) in a one stop breast unit: A prospective assessment

Abstract Background: Women's awareness about their personal breast cancer (BC) risk in the general population is generally low. Mass screening and mass prevention interventions have as yet been moderately efficient in breast oncology. "Personalized prevention" including risk communication, personalized screening and primary prevention recommendations is a promising. A personal history of BBL slightly increases subsequent BC risk. Objectives: the main objective was to evaluate the acceptability of a mathematical tool- based breast cancer risk assessment and subsequent proposal of a personalized BC prevention program in a BBL population. Secondary objectives were to evaluate information receipt, awareness, satisfaction, and anxiety. Methods: Women were eligible for the study if aged 40-74, were recently diagnosed with a benign breast lesion at the one stop breast Unit of the center, had no personal history of cancer or atypical lesions and were not BRCA carriers. Women were proposed a personalized risk assessment using a mathematical tool (BCSC score adapted to the French population-Ragusa et al) together with personalized information on risk, BC screening and prevention, release of a personalized program and evaluation of their receipt. The main end point was the proportion of women willing to have a risk assessment and personalized counseling. A cut-off point of 70% was considered critical to consider acceptability. Secondary end points were perceived BC risk, satisfaction, anxiety and distress levels at day 2 using standardized questionnaires, as well as adherence with the proposed programs. Results: Of 150 women proposed BC risk assessment and personalized prevention information between 02/2014 and 03/2015, 129 (86%) accepted. Median age: 53.6 years. 33% had a low BC risk (&amp;lt; 1.1% at 5 yrs [mean risk of 50 yrs-old women in France]), 53% a moderate risk (1.1-1.66% at 5 yrs), while 14% were high risk (&amp;gt; 1.66% at 5 yrs). 87% had never had any previous information on BC risk. 3 pts required a genetic assessment. Participants were globally very satisfied with physicians' and nurses' interpersonal skills, availability and provision of information (mean score &amp;gt; 4; range 2-5). The mean scores of clarity of the BC risk information (4.14±1;range 2-5) and screening program information (4.21±0.93; range 2-5) were high. The mean score of perceived risk level was estimated to 33.5% (SD=21.9). Mean scores of state anxiety (36.7±12.2; range 20-71), trait anxiety (39.5±8.9; range 23-59), depressive symptoms (3.4±3.3; range 0-12) and psychological distress indicated low levels of all. Higher level of state-anxiety was associated with lower scores of satisfaction with doctors and nurses human qualities (r = 0.26, p&amp;lt;.05) and with lower scores of clarity of information about screening program (r = 0.25, p&amp;lt;.05). Conclusion: The receipt of breast cancer risk assessment and personalized prevention information among women diagnosed with BBL was high (86%). Information need is high given the low level of real risk awareness. Such population may benefit from personalized prevention. Anxiety and distress scores were low and satisfaction rates high. Citation Format: Tlemsani C, Boinon D, Yung MF, Ragusa S, Mazouni C, Balleyguier C, Saghatchian M, Ghouadni A, Rivera S, Michiels S, Delaloge S. Receipt of breast cancer risk assessment and personalized prevention information among women diagnosed with a benign breast lesion (BBL) in a one stop breast unit: A prospective assessment. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P3-10-03.