Barriers to the Use of Breast Cancer Risk-Reduction Therapies

Evidence from randomized clinical trials supports the use of tamoxifen, raloxifene, exemestane, and anastrozole for the reduction of risk of invasive breast cancer, predominately estrogen receptor-positive tumors. Revised clinical guidelines now strongly recommend that physicians offer high-risk women medication for breast cancer risk reduction. Although only a small portion of eligible women receive risk reduction medication, evidence suggests higher acceptance among women with atypical hyperplasia or lobular carcinoma in situ. Among physicians, barriers for prescribing risk reduction medications include inadequate training in risk assessment, lack of reimbursement for prevention counseling, and the unavailability of easily accessible and user-friendly prediction tools for estimating risk/benefit profiles. Strategies to improve uptake among women have focused on providing education about breast cancer risk and information that accurately conveys the risks and benefits of risk reduction medications. Priority areas of research that have been identified to improve the use of risk reduction medications are the (1) development of risk assessment tools that more accurately identify women most likely to benefit, (2) identification of circulating or tissue biomarkers that can predict and monitor responsiveness of treatment, and (3) better understanding of patient-related barriers, including patients’ subjective beliefs and experiences.

Target Audience

This activity has been designated to meet the educational needs of physicians and nurses involved in the management of patients with cancer.

Learning Objectives

Upon completion of this activity, participants will be able to:

  • Understand the barriers clinicians face for prescribing breast cancer risk reduction medications
  • Explain several strategies to educate women on breast cancer risk and risk reduction strategies
  • Identify research areas to improve the use of risk reduction medication for women who are at high risk for breast cancer
Additional information
Supporters: 

No commercial support was received for this article.

Course summary
Available credit: 
  • 1.00 Participation
  • 1.00 Nurse
  • 1.00 Physician
Course opens: 
07/09/2015
Course expires: 
07/09/2016
Cost:
$0.00

Arvind Bambhroliya, MBBS, MPH
Department of Clinical Cancer Prevention
The University of Texas MD Anderson Cancer Center
Houston, Texas

Mariana Chavez-MacGregor, MD, MSc
Department of Health Services Research
The University of Texas MD Anderson Cancer Center
Houston, Texas

Abenaa M. Brewster, MD, MHS
Department of Clinical Cancer Prevention
The University of Texas MD Anderson Cancer Center
Houston, Texas

Available Credit

  • 1.00 Participation
  • 1.00 Nurse
  • 1.00 Physician

Accreditation Period

Course opens: 
07/09/2015
Course expires: 
07/09/2016

Price

Cost:
$0.00
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Required Hardware/software

To access this activity, users will need:

  • A device with an Internet connection
  • Adobe Reader or other PDF reader software for article and certificate viewing/printing