The effect of an educational intervention on the perceived risk of breast cancer

Abstract

Objective: To appraise women's perceived risk of developing breast cancer and the effects of a physician's educational intervention on this perception.

Design: Longitudinal before-and-after study involving four measures of participants risk of developing breast cancer. Eligible women provided the data needed to calculate an objective estimate of their individual risk of developing breast cancer before age 80 using the Gail formula. They also provided a subjective estimate of their individual perceived risk. Then, each participant met with a general internal medicine physician who provided personalized information and education. Immediately after education, and again several months later, we reassessed each woman's perceived risk.

Setting: Physicians office.

Participants: A convenience sample of 59 women participating in the Tamoxifen Breast Cancer Prevention Trial. Twenty-nine women returned for the follow-up risk assessment.

Measurements and main results: The median calculated risk of breast cancer before age 80 (by the Gail formula) was 15%, but the median perceived risk before educational intervention was 50%. The perceived risk after educational intervention fell to 25%. At late follow-up, the median perceived risk remained at 25%. The difference between the preeducational perceptions and the calculated estimates was significant (1) < .0001). After educational intervention, perceived risk measures shifted closer to the calculated value, but still remained significantly higher (p <.0001).

Conclusions: Women often substantially overestimate their chances of getting breast cancer. Educational intervention by a physician, including explanation of an individual's calculated risk, can reduce this error. The effect of education appears to persist at least for several months.