Breast cancer worry in higher-risk women offered preventive therapy: a UK multicentre prospective study

Abstract

Purpose Women’s worry about developing breast cancer may influence their decision to use preventive therapy. However, the direction of this relationship has been questioned. We prospectively investigated the relationship between breast cancer worry and uptake of preventive therapy. The socio-demographic and clinical factors associated with high breast cancer worry were also investigated. Methods Women at increased risk of developing breast cancer were recruited from clinics across England (n = 408). Participants completed a survey on their breast cancer worry, socio-demographic and clinical factors. Uptake of tamoxifen was recorded at 3 months (n = 258 women, 63.2%). Both primary and sensitivity analyses were conducted using different classifications of low, medium and high worry. Results 39.5% of respondents reported medium breast cancer worry at baseline and 21.2% reported high worry. Ethnic minority women were more likely to report high worry than white women (OR = 3.02, 95%CI 1.02, 8.91, p = 0.046). Women educated below degree level were more likely to report high worry than those with higher education (OR = 2.29, 95%CI 1.28, 4.09, p = 0.005). No statistically significant association was observed between worry and uptake. In the primary analysis, fewer respondents with medium worry at baseline initiated tamoxifen (low worry = 15.5%, medium = 13.5%, high = 15.7%). In the sensitivity analysis, participants with medium worry reported the highest uptake of tamoxifen (19.7%). Conclusions No association was observed between worry and uptake, although the relationship was affected by the categorisation of worry. Standardised reporting of the classification of worry is warranted to allow transparent comparisons across cohorts.

Microemulsion for Prolonged Release of Fenretinide in the Mammary Tissue and Prevention of Breast Cancer Development

“…Breast cancer is the most common type of neoplasm in women worldwide, second only to non-melanoma skin cancer, representing approximately 25% of all cancer cases. , Current strategies for prevention include mammographic screening (including mammography and breast ultrasound), preventive mastectomy, and oral chemotherapy with selective estrogen receptor (ER) modulators or aromatase inhibitors. − Apart from the mammographic screening, the other prevention strategies are not well accepted. Mastectomy causes important psychological impact and pain, while adherence to oral chemotherapy, represented by tamoxifen, raloxifene, and anastrozole, is low even in women at high risk of developing the disease, mainly due to the systemic adverse effects associated with these drugs. ,− Considering the high incidence of the disease, there is an overdue need for new, safer, and acceptable pharmacological strategies for prevention of breast cancer in high-risk population.…”