Women's Decision Making About Whether or Not to Use Breast Cancer Chemoprevention

ABSTRACT

Background: Minimal research is available that examines how women at high risk for breast cancer make choices about chemoprevention. We examined how women decide whether to use chemoprevention within the Study of Tamoxifen and Raloxifene (STAR), a non-placebo arm prevention trial.

Design: We used in-depth, semi-structured interviews and qualitative analysis. We interviewed 28 participants who chose to take chemoprevention and 23 STAR eligible women who declined participation and chemoprevention.

Results: Most participants perceived themselves at heightened risk for and anxious about developing breast cancer and believed taking either trial medication was a reasonable way to reduce risk. More than half of non-participants did not perceive themselves at heightened risk for and felt little anxiety about breast cancer. More than half of non-participants felt at greater risk for developing other diseases.

Conclusions: While breast cancer risk can be calculated with a fair degree of accuracy, its impact on women's choices about chemoprevention is likely best assessed in tandem with women's feelings about developing breast cancer, whether within the context of a clinical trial or not.

KEYWORDS:

• Breast cancer
• cancer prevention
• risk assessment
• decision making
• clinical trials