Breast Cancer Chemoprevention: A Practical Guide for the Primary Care Provider
It is recommended that risk-based counseling and chemoprevention for breast cancer is incorporated into routine care for women in the US (as well as many other countries including Australia). Some data suggests that primary care providers struggle with this, and report both discomfort and lack of knowledge on the topic. This review presents a practical, evidence-based guide for incorporating breast cancer risk assessment and chemoprevention into routine care. The step-wise approach suggested consists of (1) risk assessment and communication, (2) selection of appropriate chemoprevention based on risk–benefit analysis, (3) shared decision-making regarding chemoprevention, and (4) management of chemoprevention side effects. The evidence-based, shared decision-making approach reflects the woman’s individual preferences when communicating risk and counseling about chemoprevention. It can be incorporated over several follow-up visits, which allows the patient time to process the information and provides the clinician with a pragmatic approach to incorporating breast cancer risk assessment and chemoprevention into busy clinical practice.Â