Communicating breast cancer risk: patient perceptions of provider discussions

This study investigated the relationship between breast cancer risk communication delivered by providers and patient knowledge, perceptions, and screening practices. Telephone interviews were conducted with 141 African American (n = 71) and white (n = 70) first-degree relatives of breast cancer patients who received medical services at 2 university medical centers in North Carolina during 1994-95. Multiple items assessed subjects' reports of discussions with providers about family history and personal risk, knowledge of breast cancer risk factors, risk perceptions, breast cancer concerns, and screening practices. African American (AA) women were less likely than white women to report being informed of their increased personal risk of breast cancer because of family history. After controlling for education level, AA women aged > or = 50 years were less likely than white women to have ever had a mammogram. Both AA and white women who discussed family history and risk with their providers were significantly more likely to have had a mammogram within the past 2 years. Although these discussions seemed to increase participants' perceived risk of developing breast cancer, they did not promote knowledge of risk factors or increase levels of cancer concern. Study results indicate that provider discussions about family history and personal risk, accompanied by increases in risk perception, promote patient compliance with screening goals. Findings suggest that accurate knowledge about specific breast cancer risk factors may not be necessary to achieve screening compliance. However, additional studies are needed to investigate the relationship between knowledge of breast cancer risk factors and the adoption of behaviors associated with reducing breast cancer risk.