• Are we ready for the challenge of implementing risk-based breast cancer screening and primary prevention?

      Rainey, L; van der Waal, D; Jervaeus, A; Wengström, Y; Evans, D Gareth R; Donnelly, L; Broeders, M; Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands (2018-03-09)
      Increased knowledge of breast cancer risk factors provides opportunities to shift from a one-size-fits-all screening programme to a personalised approach, where screening and prevention is based on a woman's risk of developing breast cancer. However, potential implementation of this new paradigm could present considerable challenges which the present review aims to explore.
    • European women's perceptions of the implementation and organisation of risk-based breast cancer screening and prevention: a qualitative study

      Rainey, L; van der Waal, D; Jervaeus, A; Donnelly, LS; Evans, D Gareth R; Hammarstrom, M; Hall, P; Wengstrom, Y; Broeders, MJM; Radboud Institute for Health Sciences, Radboud university medical center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands. (2020)
    • Women's decision-making regarding risk-stratified breast cancer screening and prevention from the perspective of international healthcare professionals.

      Rainey, L; van der Waal, D; Donnelly, L; Evans, D Gareth R; Wengström, Y; Broeders, M; Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands (2018)
      Increased knowledge of breast cancer risk factors may enable a paradigm shift from one-size-fits-all breast cancer screening to screening and subsequent prevention guided by a woman's individual risk of breast cancer. Professionals will play a key role in informing women about this new personalised screening and prevention programme. Therefore, it is essential to explore professionals' views of the acceptability of this new programme, since this may affect shared decision-making.
    • Women's perceptions of personalized risk-based breast cancer screening and prevention: an international focus group study

      Rainey, L; Jervaeus, A; Donnelly, L; Evans, D Gareth R; Hammarstrom, M; Hall, P; Wengstrom, Y; Broeders, M; van der Waal, D; Radboud Institute for Health Sciences, Radboud university Medical Center, Nijmegen (2019)
      OBJECTIVE: Increased knowledge of breast cancer risk factors enables a shift from one-size-fits-all breast cancer screening to a risk-based approach, tailoring screening policy to a woman's individual risk. New opportunities for prevention will arise. However, before this novel screening and prevention program is introduced, its acceptability from a woman's perspective needs to be explored. METHODS: Women eligible for breast cancer screening in the Netherlands, United Kingdom, and Sweden were invited to take part in focus groups. A total of 143 women participated. Data were transcribed verbatim and analyzed using thematic analysis. RESULTS: Analysis identified five themes across the three countries. The first theme "impact of knowledge" describes women's concern of not being able to unlearn their risk, perceiving it as either a motivator for change or a burden which may lead to stigma. The second theme "belief in science" explains women's need to trust the science behind the risk assessment and subsequent care pathways. Theme three "emotional impact" explores, eg, women's perceived anxiety and (false) reassurance, which may result from knowing their risk. Theme four "decision making" highlights cultural differences in shared versus individual decision making. Theme five "attitude to medication" explores the controversial topic of offering preventative medication for breast cancer risk reduction. CONCLUSIONS: Acceptability of risk-based screening and prevention is mixed. Women's perceptions are informed by a lack of knowledge, cultural norms, and common emotional concerns, which highlights the importance of tailored educational materials and risk counselling to aid either shared or individual informed decision making.