Abstract P5-08-23: Personalized, prevention decision aid developed for breast cancer risk-reducing discussions and interventions in the WISDOM study

Problem statement: Breast cancer risk reduction has been validated by Level I evidence generated in large-scale clinical trials, however uptake of chemoprevention among women at high risk remains very low. Methods: A patient-facing shared decision-making aid was designed to inform women enrolled in the PCORI-funded WISDOM Study of their individualized breast cancer risk and ways to reduce their risk. It built upon a breast health decision tool used for the prior ten years. The tool displays the key factors that are used to calculate a participant’s risk (Breast Cancer Surveillance Consortium [BCSC] and Polygenic Risk Score). The aid also estimates the anticipated change in a participant’s risk due to particular risk-reduction interventions (medication, lifestyle). After Institutional Review Board approval, we used a mixed-methods analysis to evaluate the decision aid. Expert opinion was sought from decision scientists, low literacy experts, breast health specialists, epidemiologists, and breast cancer specialists, in order to generate a tool with suitable language and adequate communication of content. We piloted the decision-making aid with 15 elevated risk WISDOM Study participants without a common mutation associated with breast cancer. Results: To date, the pilot has enrolled 10 elevated-risk participants with an average age of 63. Six have completed the quantitative survey. 3 (50%) indicated that they would consider chemoprevention. 6 (100%) indicated that they would consider lifestyle changes, such as exercise or reducing their body mass index (BMI). 3 (50%) indicated the aid has been “extremely helpful” and 6 (100%) indicated that they had a better understanding of their breast cancer risk. Participants also indicated the benefit of visuals and greater engagement with high-risk counselors when using the aid. The full pilot data plus the ongoing experience will be presented. Conclusion: The WISDOM Study shared decision-making aid represents a novel, participant-centered approach to integrate breast cancer prevention and personal breast cancer risk. This decision aid will be used in the WISDOM Study to evaluate whether risk-based screening will improve uptake of chemoprevention in the WISDOM Study population. Citation Format: Holly Keane, Yash Huilgol, W. Patrick Shibley, Yiwey Shieh, Deborah Goodman, Jeff Tice, Jeff Belkora, Karen Sepucha, Elissa Ozzane, Allison Fiscalini, Laura Esserman. Personalized, prevention decision aid developed for breast cancer risk-reducing discussions and interventions in the WISDOM study [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P5-08-23.