--- title: "Breast cancer chemoprevention in primary care. | Sutter Health" description: "PCPs infrequently assess breast cancer risk and rarely prescribe chemoprevention drugs for risk reduction." url: "https://www.sutterhealth.org/research/publications/breast-cancer-chemoprevention-in-primary-care-1055312742" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Breast cancer chemoprevention in primary care. # Breast cancer chemoprevention in primary care - assessing readiness for change. Wang H, Snyder CF, Larson S, Vogel V, Kirchner HL, Sun H, & Yan X. 24(6):283-288. _Qual Prim Care._ 2016-11-01 ## Abstract Purpose: Despite breast cancer chemoprevention recommendations, chemoprevention use remains low. We assess primary care providers’ (PCP) awareness and use of breast cancer chemoprevention, and perceived barriers/ solutions. Methods: We conducted an online survey to investigate PCPs’ awareness and use of breast cancer chemoprevention, and perceived barriers/solutions. 161/426 (38%) eligible PCPs completed the survey.Results: Of providers, 42% reported using breast cancer risk assessment models, only 9% prescribed breast cancer chemoprevention drugs in the past year. Providers using risk models were more likely to have made a breast cancer diagnosis in the past year (77% vs. 56%; p=0.01). Providers prescribed chemoprevention were older (mean 49 years vs. 40; p=0.01), more likely to be in practice ≥ 10 years (71% vs. 43%; p=0.04) and full time (79% vs. 49%; P=0.04); they all had diagnosed breast cancer in the past year (100% vs. 61%; p=0.002). Top three reported barriers to chemoprevention guideline adherence were lack of knowledge about chemoprevention drugs, unaware of chemoprevention guidelines, and inability to identify high-risk women. After adjustment for other provider characteristics and barriers, the PCPs who are unaware of chemoprevention guidelines have 3.1 increased odds (CI: 1.4-6.7) for not using risk assessment models. If high-risk women can be identified, 85% of respondents prefer referring appropriate women to a high-risk breast clinic. Conclusion: PCPs infrequently assess breast cancer risk and rarely prescribe chemoprevention drugs for risk reduction. PCP education on breast cancer prevention and establishing high-risk breast clinics may improve breast cancer chemoprevention uptake. [PubMed abstract](https://ascopubs.org/doi/abs/10.1200/JCO.2016.34.15_suppl.1547) ![Xiaowei (Sherry) Yan, Ph.D.](https://dyn.mktgcdn.com/p/NTWox_hkmxIRiqJEc5PXKeBkfR_WMtpSQbEI4J69Xls/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) Xiaowei (Sherry) Yan, Ph.D. Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/xiaowei-sherry-yan-phd-1049681042) ## Research topics - [Breast Cancer](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Breast+Cancer%5C%22%22) - [All Cancer](https://www.sutterhealth.org/research-search-results?query=%22%5C%22All+Cancer%5C%22%22) - [Prevention and Health Maintenance](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Prevention+and+Health+Maintenance%5C%22%22) - [Women's Health](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Women%27s+Health%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Higher absolute lymphocyte counts predict lower mortality from early-stage triple-negative breast cancer.](https://www.sutterhealth.org/research/publications/higher-lyphocyte-count-predict-lower-mortality-breast-ca-1055312328) Afghahi A, Purington N, Han SS, Desai M, Pierson E, Mathur MB, Seto T, Thompson CA, Rigdon J, Telli ML, Badve SS, Curtis C, West RB, Horst K, Gomez SL, Ford JM, Sledge GW, Kurian AW. Clin Cancer Res. pii: clincanres.1323.2017. doi: 10.1158/1078-0432.CCR-17-1323. \[Epub ahead of print\] 2018 Mar 26 - Publication ### [Engaging patients in decisions about cancer screening: exploring the decision journey through the use of a patient portal.](https://www.sutterhealth.org/research/publications/cancer-screening-decisions-pt-portal-1055312320) Woolf SH, Krist AH, Lafata JE, Jones RM, Lehman RR, Hochheimer CJ, Sabo RT, Frosch DL, Zikmund-Fisher BJ, Longo DR. Am J Prev Med. pii: S0749-3797(17)30650-5. doi: 10.1016/j.amepre.2017.10.027. \[Epub ahead of print\] 2017 Dec 11 - Publication ### [Redefining risk and benefit: understanding the decision to undergo contralateral prophylactic mastectomy.](https://www.sutterhealth.org/research/publications/risk-benefit-contralateral-prophylactic-mastectomy-1055312871) Rendle KA, Halley MC, May SG, Frosch DL. Qual Health Res. pii: 1049732314557085. \[Epub ahead of print\] 2014 Nov 04 - Publication ### [Physicians' perceptions of shared decision-making behaviours: a qualitative study demonstrating the continued chasm between aspirations and clinical practice.](https://www.sutterhealth.org/research/publications/doctors-perceptions-shared-dec-making-behs-1055312533) Zeuner R, Frosch DL, Kuzemchak MD, Politi MC. Health Expect. 18(6):2465-76. doi: 10.1111/hex.12216. Epub 2014 Jun 17. 2015 Dec 01 - Publication ### [Genomic testing & therapies for breast cancer in clinical practice.](https://www.sutterhealth.org/research/publications/genomic-testing-therapies-for-breast-cancer-1055312617) Haas JS, Phillips KA, Liang SY, Hassett MJ, Keohane C, Elkin EB, Armstrong J, Toscano M. J Oncol Pract. 7(3 Suppl):e1s-7s. doi: 10.1200/JOP.2011.000299 2011 May 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/breast-cancer-chemoprevention-in-primary-care-1055312742#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Breast cancer chemoprevention in primary care."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/breast-cancer-chemoprevention-in-primary-care-1055312742#medicalscholarlyarticle","name":"Breast cancer chemoprevention in primary care - assessing readiness for change.","headline":"Breast cancer chemoprevention in primary care.","abstract":"Purpose: Despite breast cancer chemoprevention recommendations, chemoprevention use remains low. We assess primary care providers’ (PCP) awareness and use of breast cancer chemoprevention, and perceived barriers/ solutions. Methods: We conducted an online survey to investigate PCPs’ awareness and use of breast cancer chemoprevention, and perceived barriers/solutions. 161/426 (38%) eligible PCPs completed the survey.Results: Of providers, 42% reported using breast cancer risk assessment models, only 9% prescribed breast cancer chemoprevention drugs in the past year. Providers using risk models were more likely to have made a breast cancer diagnosis in the past year (77% vs. 56%; p=0.01). Providers prescribed chemoprevention were older (mean 49 years vs. 40; p=0.01), more likely to be in practice ≥ 10 years (71% vs. 43%; p=0.04) and full time (79% vs. 49%; P=0.04); they all had diagnosed breast cancer in the past year (100% vs. 61%; p=0.002). Top three reported barriers to chemoprevention guideline adherence were lack of knowledge about chemoprevention drugs, unaware of chemoprevention guidelines, and inability to identify high-risk women. After adjustment for other provider characteristics and barriers, the PCPs who are unaware of chemoprevention guidelines have 3.1 increased odds (CI: 1.4-6.7) for not using risk assessment models. If high-risk women can be identified, 85% of respondents prefer referring appropriate women to a high-risk breast clinic. Conclusion: PCPs infrequently assess breast cancer risk and rarely prescribe chemoprevention drugs for risk reduction. PCP education on breast cancer prevention and establishing high-risk breast clinics may improve breast cancer chemoprevention uptake.","description":"PCPs infrequently assess breast cancer risk and rarely prescribe chemoprevention drugs for risk reduction.","keywords":["Breast Cancer","All Cancer","Prevention and Health Maintenance","Women's Health"],"datePublished":"2016-11-01","url":"https://www.sutterhealth.org/research/publications/breast-cancer-chemoprevention-in-primary-care-1055312742","inLanguage":"en-US","isPartOf":{"@type":"Periodical","name":"Qual Prim Care"},"sourceOrganization":{"@type":"MedicalOrganization","name":"Palo Alto Medical Foundation Research Institute"},"about":[{"@type":"DefinedTerm","name":"Breast Cancer","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Breast+Cancer%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"All Cancer","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22All+Cancer%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Prevention and Health Maintenance","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Prevention+and+Health+Maintenance%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Women's Health","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Women%27s+Health%22%5D%7D%5D&verticalKey=research_publication"}],"mainEntityOfPage":{"@type":"WebPage","@id":"https://www.sutterhealth.org/research/publications/breast-cancer-chemoprevention-in-primary-care-1055312742","breadcrumb":{"@id":"https://www.sutterhealth.org/research/publications/breast-cancer-chemoprevention-in-primary-care-1055312742#breadcrumblist"}}} ```