Abstract P001: Frequency and covariates of chemoprevention use among women at high risk for breast cancer
Authors: Conley Claire C. , Rodriguez Jennifer , O’Neill Suzanne C. , Vadaparampil Susan T. 
Published: January 2023

Purpose: To assess patterns of self-reported use of chemopreventive medications (i.e., tamoxifen, raloxifene) among women with elevated risk for breast cancer. Methods: Women with elevated breast cancer risk (N=134; n=98 BRCA1/2 mutation carriers, n=36 with ≥1.67% 5-year breast cancer per the National Cancer Institute [NCI] Breast Cancer Risk Assessment Tool [BCRAT; https://bcrisktool.cancer.gov/]) were recruited by advertising on social media and through community organizations. Between August 2020 and January 2021, participants completed an online survey assessing demographic characteristics (race, ethnicity, education, employment, income, insurance, and usual healthcare setting), psychosocial characteristics (perceived breast cancer risk, self-efficacy), provider recommendation for breast cancer chemoprevention, and prior/current use of breast cancer chemoprevention. Descriptive statistics characterized the frequency of provider recommendation for and use of breast cancer chemoprevention. Multivariable logistic regression analysis examined demographic and psychosocial characteristics associated with use of breast cancer chemoprevention. Results: Participants were in middle adulthood (M=45) and mostly non-Hispanic White (90%), with ≥ Bachelor’s degree (69%), household income ≥ $50,000/year (67%), and private health insurance (69%). Most were employed outside the home (73%) and typically received medical care at a private doctor’s office (81%). Most (76%) had discussed their breast cancer risk with a healthcare provider. About one-third (33%) reported receiving a provider recommendation for tamoxifen or raloxifene, 16% had previously taken one of these medications, and 10% were currently taking one of these medications. This included 24% of participants with a BRCA1/2 mutation and 35% of participants with a 5-year breast cancer risk ≥1.67%; use of chemoprevention did not differ between these groups (p=0.22). Compared to participants with private health insurance, those who were publicly insured were more likely to have taken chemoprevention medications (OR=8.27, p=0.04, 95% C.I.=1.95-35.11). No other demographic or psychosocial characteristics were associated with chemoprevention use (all p’s≥0.09). Conclusions: Consistent with prior research, few women with elevated breast cancer risk reported currently or previously taking chemopreventive medications. Despite little data on the efficacy of chemoprevention for BRCA1/2 mutation carriers, self-reported use of chemoprevention did not differ based on BRCA1/2 mutation status. Insurance status emerged as a key predictor of chemoprevention use, indicating that cost and insurance coverage may be a barrier for some women and may need to be addressed in interventions aiming to increase use of chemoprevention. Given the homogenous convenience sample, results might not extend to the broader population and need to be replicated in larger, more diverse samples.

Citation Format: Claire C. Conley, Jennifer Rodriguez, Suzanne C. O’Neill, Susan T. Vadaparampil. Frequency and covariates of chemoprevention use among women at high risk for breast cancer. [abstract]. In: Proceedings of the AACR Special Conference: Precision Prevention, Early Detection, and Interception of Cancer; 2022 Nov 17-19; Austin, TX. Philadelphia (PA): AACR; Can Prev Res 2023;16(1 Suppl): Abstract nr P001.