Reviewer’s report
Title: 
Understanding Low Chemoprevention Uptake by Women at High Risk of Breast Cancer: Findings
from a Qualitative Inductive Study of Women’s Risk-Reduction Experiences
Version: 
2 
Date: 
14 Jul 2020
Reviewer's report:
The authors conducted qualitative interviews to better understand reasons for low chemoprevention
uptake. The authors should address the following minor concerns about patient selection for this
qualitative study:
1) In general, chemoprevention is only approved for women, 35 years of age or older, however, this study
sample includes women, age 21 to 69 years. Were women under 35 years old being offered
chemoprevention?
2) The study mainly consists of women with hereditary breast cancer syndromes (such as BRCA1/2
mutations) or a strong family history of breast or ovarian cancer. Were other high-risk women with
atypical hyperplasia or lobular carcinoma in situ included, since they are more likely to benefit from
selective estrogen receptor modulators (SERMs) or aromatase inhibitors (AIs) for breast cancer
chemoprevention? In general, women with BRCA1 mutations are less likely to benefit from SERMs or
AIs for primary prevention, since the majority of breast cancers that develop among these women are
hormone receptor-negative.
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