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Diagnosed with breast cancer while on a family history

screening programme: an exploratory qualitative study

A. CLEMENTS, bsc, senior research nurse, Cancer Research UK Primary Care Education Research Group,

University of Oxford, Department of Primary Health Care, Oxford, B.J. HENDERSON, phd, research psycholo-

gist, Institute of Medical & Social Care Research, Ardudwy, Normal Site, University of Wales, Bangor, Gwynedd,

S. TYNDEL, ba, research officer, Cancer Research UK Primary Care Education Research Group, University of

Oxford, Department of Primary Health Care, Oxford, G. EVANS, md frcp, consultant in medical genetics,

Department of Clinical Genetics, St Mary’s Hospital, Manchester, K. BRAIN, phd, senior research fellow,

Institute of Medical Genetics, University of Wales College of Medicine, Heath Park, Cardiff, J. AUSTOKER, phd,

director, Cancer Research UK Primary Care Education Research Group, University of Oxford, Department of

Primary Health Care, Oxford, & E. WATSON, phd, deputy director, Cancer Research UK Primary Care Educa-

tion Research Group, University of Oxford, Department of Primary Health Care, Oxford, UK for the PIMMS Study

Management Group*

CLEMENTS A., HENDERSON B.J., TYNDEL S., EVANS G., BRAIN K., AUSTOKER J. & WATSON E. FOR

THE PIMMS STUDY MANAGEMENT GROUP (2008) European Journal of Cancer Care 17, 245–252

Diagnosed with breast cancer while on a family history screening programme: an exploratory qualitative study

Mammographic screening is offered to many women under 50 in the UK who are at moderate or high risk of

developing breast cancer because of their family history of the disease. Little is understood about the impact

of screening on the emotional well-being of women with a family history of breast cancer. This qualitative

study explores the value that women at increased risk placed on screening, both pre- and post-cancer diagnosis

and the impact of the diagnosis. In-depth interviews were undertaken with 12 women, aged 35–50, diagnosed

with breast cancer while on an annual mammographic screening programme. Women described the strong

sense of reassurance gained from screening prior to diagnosis. This faith in screening was reinforced by early

detection of their cancer. Reactions to diagnosis ranged from devastation to relief at having finally developed

a long-expected condition. Despite their positive attitudes about screening, not all women wanted to continue

with surveillance. For some, prophylactic mastectomy was preferable, to reduce future cancer risk and to

alleviate anxieties about the detection of another cancer at each subsequent screen. This study illustrates the

positive yet diverse attitudes towards mammographic screening in this group of women with a family history

of breast cancer.

Keywords: breast cancer, early screening programme, family history, qualitative.

Correspondence address: Alison Clements, Cancer Research UK Primary Care Education Research Group, University of Oxford, Department of Primary

Health Care, Rosemary Rue Building, Old Road Campus, Old Road, Headington, Oxford, OX3 7LF, UK (e-mail: .ac.uk).

Ethical approval: London Multi-Centre Research Ethics Committee (MREC) 02/2/97.

*Other members of the A Psychosocial Evaluation of the Impact of Mammographic Surveillance Services on Women under 50 at moderate or high risk of

inherited breast cancer (PIMMS) Study Management Group: Stephen Duffy, Cancer Research UK Department of Statistics, London; Hilary Fielder, Screening

Services, Velindre National Health Service (NHS) Trust; Jonathon Gray, Institute of Medical Genetics, University Hospital of Wales; Douglas Macmillan,