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Patient and Physician Perspectives on Using Risk Prediction to Support Breast Cancer Surveillance Decision Making.

Christine M Gunn1,2, Nancy Boyer3, Sidra Sheikh3

  • 1The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth College, Lebanon, NH, USA.

Medical Decision Making : an International Journal of the Society for Medical Decision Making
|October 21, 2025
PubMed
Summary

Breast cancer survivors face a higher risk of interval cancers. A new risk prediction tool, supplementing patient-physician communication, was positively received by both survivors and doctors for enhancing surveillance decisions.

Keywords:
breast cancermammographyrisk predictionshared decision makingsurveillancesurvivorship

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Area of Science:

  • Oncology
  • Public Health
  • Medical Informatics

Background:

  • Breast cancer survivors have an elevated risk of developing interval cancers compared to the general screening population.
  • Predicting the risk of a second breast cancer in survivors can be informed by primary cancer and treatment characteristics.
  • Patient and physician perspectives on using risk prediction tools for surveillance decision-making are not well understood.

Purpose of the Study:

  • To explore breast cancer survivors' and physicians' perceptions of an interval cancer risk prediction tool.
  • To understand how such tools might enhance surveillance decision-making in breast cancer care.
  • To identify patient and physician views on the design, relevance, and utility of risk prediction tools.

Main Methods:

  • A qualitative study involving semi-structured focus groups with breast cancer survivors and individual interviews with physicians.
  • Participants were recruited from Breast Cancer Surveillance Consortium registries.
  • Data were analyzed using thematic analysis.

Main Results:

  • Two key themes emerged: 1) Risk prediction tools can enhance patient-centered care and add value to surveillance.
  • 2) These tools can improve communication regarding the risk of in-breast recurrence or new breast cancer.
  • Both patients and physicians found tools with strong evidence and accessible outputs valuable for shared decision-making.

Conclusions:

  • Breast cancer survivor and physician perceptions of a novel risk prediction tool for surveillance imaging decisions were positive.
  • The tool was viewed favorably when presented as a supplement to the existing patient-physician relationship.
  • Future research should focus on implementation in clinical settings to improve shared decision-making and patient outcomes.