First Advisor

Dunemn, Kathleen

Date Created

12-2016

Abstract

This capstone project was an evidence-based quality improvement project with three objectives: (a) to understand current practice of primary breast cancer chemoprevention in an integrated health system; (b) to evaluate the most current evidence available and the U.S. Preventive Services Task Force’s (2013) Breast Cancer: Medications for Risk Reduction recommendation; and (c) to plan for implementation of the recommendation as a clinical practice guideline and evaluate the guideline outcomes through a future pilot study. The pilot study was not part of the capstone but included for planning purposes. Evidence exists of the effectiveness of selective estrogen receptor modulators and aromatase inhibitors for risk reduction of primary breast cancer for women at high risk for the development of breast cancer. Recommendations have been published by national prevention and oncology organizations advocating use of these pharmacologic agents in the high-risk female population. Despite good evidence, the use of medications to prevent breast cancer among women at high risk has not been put into practice. Local data support that women at high risk of breast cancer have not been educated about nor offered medications to reduce their risk. A Delphi method was used to understand obstacles to recommendation of chemoprevention and strategies to facilitate discussions with high-risk women. The development and implementation of a clinical practice guideline for breast cancer risk reduction would increase use of current evidence consistent with national standards of care, inform women of options for breast cancer risk reduction, and engage healthcare providers in shared decision-making with women relevant to breast cancer risks.

Keywords

Breast cancer; Chemoprevention

Extent

133 pages

Local Identifiers

KottmanCapstone2016

Rights Statement

Copyright is held by the author.

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