BCa: why is chemoprevention uptake so low?

  • Flanagan MR & al.
  • Ann Surg Oncol
  • 27/02/2019

  • Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Only 24% of women at high risk for breast cancer (BCa) opt for chemoprevention, according to a retrospective cohort study.
  • Younger age (

Why this matters

  • Chemoprevention with selective estrogen receptor modulations or aromatase inhibitors is a proven option for high-risk women to reduce BCa risk, as recommended by multiple organizations, including the US Preventive Services Task Force.
  • Understanding risk factors for nonuse is key to targeting education and counseling.

Study design

  • Retrospective cohort of 1506 women enrolled in a high-risk screening program from 2014 to 2017 at the Memorial Sloan Kettering Cancer Center in New York City.
  • Funding: NIH

Key results

  • 24% of the cohort had prior/current chemoprevention.
  • Women
  • Having multiple risk factors for chemoprevention (e.g., having family history or lobular carcinoma in situ), occurring in 38.6% of the cohort, did not increase the likelihood of use.
  • In women with a documented discussion regarding chemoprevention (n=575), fear of adverse effects was the single most common reason for refusal (n=57/156 patients who refused).
  • 61% of women who started chemoprevention completed it (5 years).

Limitations

  • Single-center study.
  • Retrospective, observational design.