Breast cancer risk elements and nurse practitioners' knowledge, use, and perceived comfort level of breast cancer risk assessment

Purpose: The purpose of this study was to describe nurse practitioners' (NPs') knowledge, use, and perceived comfort level in providing breast cancer risk assessment to women in clinical settings. Data sources: This descriptive study was part of a needs assessment to determine if education and training programs on breast cancer risk assessment are warranted for NPs. A convenience sample of 147 NPs completed surveys to assess their knowledge of breast cancer risk assessment and use of empiric breast cancer risk assessment tools, and to evaluate their perceived comfort level in assessing women's risk for developing breast cancer. Conclusions: Assessing women's risk for the development of breast cancer is important in providing primary and secondary preventive strategies such as chemoprevention, lifestyle changes, and enhanced surveillance that may reduce a woman's risk for developing the disease. Although 51.4% of NPs reported providing breast cancer risk assessment, few (37%) reported use of family history or the Gail model (6%) to determine their patients' breast cancer risk. NPs' knowledge of breast cancer risk assessment and use of empiric risk assessment models were low. The majority (71%) of NPs felt uncomfortable or a low level of comfort in conducting breast cancer risk assessment. Implications for practice: Excluding skin cancer, breast cancer is the leading cause of cancer and second leading cause of cancer death among women in the United States. Breast cancer risk assessment is important in identifying women who may be at high risk for developing the disease. At the front line in health care, NPs can play a vital role in assessing women's risk for breast cancer. These findings suggest that education and training may be warranted to enhance knowledge and use of empiric risk models to increase the comfort level of NPs in conducting breast cancer risk assessment to their patients.