Health beliefs and behaviours amongst women at high risk of breast cancer: An in-depth interview study

Abstract

Aims: This study aims to explore the health beliefs and the reasons for these beliefs amongst BRCA mutation carriers. Design: This study used a qualitative research design through one to one interviews. A semi structured interview guide was developed around the phenomenon being investigated. Data collection was through audio recordings of interviews. Tapes were transcribed verbatim. Transcriptions were coded for emerging themes using Framework Analysis. Elements of Discourse Analysis were also applied. Subjects: 20 women either BRCA1 or BRCA2 mutation carriers, affected or unaffected by breast cancer, or at a 50% risk of being a BRCA carrier. Findings: Genetic factors are perceived to be the strongest element when assessing breast cancer risk. Secondary factors quoted included a wide variety of other causes, environment, stress, diet, exercise and smoking. Participants were aware of their raised breast cancer risk. The majority of the group had made changes to their behaviour. The perceived benefits of these changes were, improved outcome if they did develop breast cancer in the future, positive effects on general health and ensuring that they had done whatever they could to reduce possible causes. Belief that a behaviour was a risk factor in the development of breast cancer was not always correlated with changes in that behaviour. Some individuals did not believe particular behaviours were risk factors yet still made changes to those behaviours. The majority of the group were willing to join future lifestyle based trials but were generally reluctant to be involved in drug based investigations. Conclusions: Despite the wide spread belief that their breast cancer risk was largely predetermined by genetic factors the group displayed strong motivation to find other ways to exercise control over their breast cancer risk and the possible outcome if breast cancer did occur. If clear causal links between behaviour and breast cancer occurrence can be proven for this specific population group, it may be expected that the group’s strong motivation to affect some control over their increased breast cancer risk would lead them to engage in this protective behaviour.