Archives
br Facilitator Would you go to
12
Facilitator: Would you go to the internet before going to a [PCP]?
Consumer: Yes, I would. Because you get big amounts of information and you have it MG-132 now . You don't have it in five days when
you can get an appointment and for $35 out of pocket plus your Medicare rebate. And you can sit there and read for two hours if
you want to, whereas you've got fifteen minutes with the PCP.
specialist [29], indicating support for the notion that PCPs do not currently see breast cancer as the domain of primary care. It is timely to reconsider this issue and reflect on who should be responsible for the domain of cancer prevention, especially given the international interest in stratified or risk based screening and the increasing availability of information about individual risk [30].
Women reported a large amount of ‘hype’ about breast cancer in the media, (including a great deal of fundraising) and despite the availability of ample generic information about BC, few had a clear idea of their own risk, or the specific recommendations tailored to their risk. Women felt that despite all the publicity and promotion, there was little concrete support available for prevention (in the absence of a BRCA1 or BRCA2 gene mutation). All women reported they should conduct regular BSE, despite the change in recom-mendation from monthly BSE to ‘breast awareness’ occurring around 2009, due to a lack of evidence of benefit. This highlights
the need for attention not only on the implementation of new prevention options, but also on the de-implementation of recom-mendations found to be unsuccessful [31]. All were aware of the recommendation to undertake two yearly mammograms through BreastScreen from age 50, yet none had heard of risk-reducing medication for women at moderately increased risk of breast cancer, indicating the need for better dissemination of new rec-ommendations beyond prevention guidelines. These mis-understandings and misgivings suggest that ‘one size fits all’ approach to health promotion about breast cancer may not be serving women well, and that recognition of the range of risk levels that exist in any population, and a capacity to address changes in recommendations as a component of health promotion is war-ranted. Future research must address the actual uptake of risk assessment by women, and the role that women's psychological characteristics and social environment play in uptake and response
Table 5
Example quotes to support analysis of consumers and clinician discussions during Part 2 of the focus groups e responses to iPrevent®.
Code
No Example quotes
Benefits of using a tool like iPrevent®
Clinicians
1
The precision and the options would make it a lot more sophisticated
2
The ten year risk compared to the lifetime risk I think is really good. Particularly for women of certain ages. For a 25-year old woman, what's her risk at 35,
compared with what's her lifetime risk?.. I sometimes feel that women don't comprehend a lot when all we give them is a lifetime risk.
3
Clinician: Do we currently speak to moderate risk about drugs?
Clinician: No, we don't.
Clinician: No, we haven't tended to. We should be, according to guidelines.
Clinician: Yes
4
I suppose it's formalizing and making sure you're less likely to miss something for a particular patient, if you weredI suppose we don't normally talk about medical
prevention with like moderate risk, so I'm just saying we formalize. You're less likely to miss a step if …
5
Certainly, if breast cancer risk assessment moves more away from an FCC and more into the [PCP] realm, then you need a way to make it as consistent as possible.
So that high-risk women are getting called high-risk, and moderate, moderate, et cetera.
Consumers
6
I think the benefit is you're empowering yourself with information, you're possibly changing what you can change