Exploring communication preferences for disclosing breast cancer risk in women with a family history

Abstract

Effective breast cancer (BC) screening relies on shared decision-making and clear communication to help patients understand their risk and choose strategies aligned with that risk. The CanRisk tool was used to estimate BC risk in healthy women with a familial history of BC and the absence of a pathogenic variant in BC genes. Results were disclosed to patients using different formats, and data were collected to analyze the association between patient characteristics and risk communication preferences. Participants preferred their risk explained by percentages (59%) over fractions (15%), icon arrays (13%) or risk groups (13%) and 10-year risk estimation was favored to remaining lifetime risk (71% vs. 22%). Participants highlighted the use of positive and negative formats and comparison with the population's risk formats, and line graphic (61%) was selected over numerical table or a color-graph (19% each). However, participants with lower numeracy preferred color graphics (OR: 1.42; 95% CI 1.15–1.77 p = 0.001). The use of percentages, line graphics, and 10-year risk formats are highly accepted for healthy participants with a family history of BC, although adaptation may be needed for those with lower numeracy skills.