Specialist recommendation for chemoprevention medications in patients at familial risk of breast cancer: a cross-sectional survey in England

Lee, Siang Ing; Curtis, Helen; Qureshi, Sadaf; Dutton, Brittany; Qureshi, Nadeem

Abstract

In England, the National Institute for Health and Care Excellence guideline for familial breast cancer recommends chemoprevention for women at high and moderate familial risk of breast cancer. However, prescribing of chemoprevention has not improved since the introduction of the guideline in 2013. The study aims to identify the current practice, in England, of familial cancer specialists offering chemoprevention and recommending prescribing in primary care. This was an anonymised national cross-sectional survey of familial breast cancer risk services in England. Lead clinicians were sent an online survey link. The survey questions included whether chemoprevention was offered/considered for high and moderate risk women, when chemoprevention prescribing and recommendation to primary care started, medications prescribed, age groups considered for chemoprevention and existence of a shared prescribing protocol with primary care. The survey was sent to 115 hospital services, responses from 50 services (43%) were included in the analysis. Of the 40 services offering chemoprevention for high risk women, 15 (38%) did not prescribe but 31 (78%) recommended prescribing to primary care. Of the 31 services considering chemoprevention for moderate risk, eight (26%) did not prescribe with 26 (84%) recommended prescribing to primary care. Only three services reported having a shared protocol with primary care. Within three years of the guidelines, many services recognised the role of chemoprevention for both high and moderate risk with a key role for primary care to initiate prescribing. However, there is still room for improvement.

Citation

Lee, S. I., Curtis, H., Qureshi, S., Dutton, B., & Qureshi, N. (2021). Specialist recommendation for chemoprevention medications in patients at familial risk of breast cancer: a cross-sectional survey in England. Journal of Community Genetics, 12(1), 111–120. https://doi.org/10.1007/s12687-020-00490-4

• Journal Article Type: Article
• Acceptance Date: Oct 19, 2020
• Online Publication Date: Oct 28, 2020
• Publication Date: 2021-01
• Deposit Date: Oct 20, 2020
• Publicly Available Date: Oct 29, 2021
• Journal: Journal of Community Genetics
• Print ISSN: 1868-310X
• Electronic ISSN: 1868-6001
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 12
• Issue: 1
• Pages: 111–120
• DOI: https://doi.org/10.1007/s12687-020-00490-4
• Keywords: genetic predisposition to disease, breast neoplasm, familial breast cancer, guidelines
• Public URL: https://nottingham-repository.worktribe.com/output/4980054
• Publisher URL: https://link.springer.com/article/10.1007/s12687-020-00490-4