Nigerian Breast Cancer Risk-Reduction Study (NBCRS)

Effects of Risk Assessment and Counselling on Adherence to Risk Reduction Recommendations Among Female Relatives of Breast Cancer Patients in Southwestern Nigeria

Lagos State University Teaching Hospital (LASUTH), Obafemi Awolowo University Teaching Hospital, Lagos University Teaching Hospital (LUTH), University College Hospital, Ibadan

The study will be a randomized controlled trial. The aim of the study is to determine the Breast Cancer (BC) risk and to evaluate the effect of BC risk counseling on lifestyle changes and adherence to risk-reduction practices among first-degree female relatives of BC patients in South-West Nigeria. This study's research questions are: What are the Nigeria Breast Cancer Study (NBCS) and Gail models estimates of the BC risk of first-degree female relatives of BC patients in South-West, Nigeria? What are the effects of BC risk assessment and counseling on adherence to breast screening recommendations among first-degree female relatives of BC patients in South-West, Nigeria? What are the effects of BC risk assessment and counseling on adherence to lifestyle risk reduction recommendations among first-degree female relatives of BC patients in South-West, Nigeria? What is the knowledge, attitudes, and perception of first-degree female relatives of BC patients in South-West Nigeria towards genetic testing and BC etiology? What factors predict breast screening among first-degree female relatives of BC patients in South-West Nigeria? What factors predict the time to first BC screening (post-intervention) among first-degree female relatives of BC patients in South-West Nigeria? Participants will be randomized into the control arm (standard care) and intervention arms of the study. The intervention arm of the study will have a BC risk assessment followed by individualized BC risk counseling. In addition, the intervention arm will receive BC awareness and MammaCare® BSE training. The control arm will receive only standard care comprising BC awareness and MammaCare® BSE training. Both study arms will receive BC screening recommendations and lifestyle modification recommendations. We hope that the BC risk counseling will improve BC screening practices and modification of risk behaviors and this hypothesis will be tested.

Risk Reduction Behavior, Breast Cancer, Health Behavior, Health Care Utilization, Health Knowledge, Attitudes, Practice

Breast cancer, First-degree relatives, Breast cancer prevention, Risk assessment, Risk counselling, Southwest Nigeria

Participants received one-on-one breast cancer awareness education; one-on-one monthly Breast Self-Examination (BSE) training; general breast cancer screening recommendations; and general lifestyle modification recommendations

Participants received Standard care as described in the SC arm above in addition to individualized breast cancer risk assessment, individualized breast cancer risk counseling, and lifestyle risk reduction recommendations

Individualized breast cancer risk assessment: The Nigerian Breast Cancer Study (NBCS) absolute risk prediction model was used to predict the 5-year and lifetime breast cancer risks of the participants. The model utilized individual breast cancer risk factors.

Individualized breast cancer risk counselling: The Principal Investigator (PI) and other trained risk counsellors discussed the results of the NBCS risk prediction model with participants and counselled them about the risk of developing breast cancer. The

Effects of BC risk assessment and counselling on adherence to breast screening recommendations among first-degree female relatives of BC patients in South-West Nigeria

Questionnaire will be administered to the participants to determine the effects of the intervention on adherence to breast screening practices

Effects of BC risk assessment and counselling on adherence to lifestyle risk reduction recommendations among first-degree female relatives of BC patients in South-West, Nigeria

Questionnaire will be administered to the participants to determine the effects of the intervention on adherence to lifestyle risk reduction practices

Predictors of time to first BC screening post-intervention among first-degree female relatives of BC patients in South-West Nigeria

Statistical analysis will be carried out to determined the independent variables predicting first time to BC screening

Determine the perception of familial BC risk among first-degree female relatives of BC patients in South-West Nigeria.

Semi-structured questionnaires will be used to determine the perception of familial BC risk among participants

Determine the knowledge of familiar BC risk among first-degree female relatives of BC patients in South-West Nigeria.

Semi-structured questionnaires will be used to determine the knowledge of familiar BC risk among participants

Determine the knowledge, attitude, and perception towards genetic testing and BC aetiology among first-degree female relatives of BC patients in South-West Nigeria

Semi-structured questionnaires will be used to determine the knowledge, attitude, and perception towards genetic testing and BC aetiology among participants

Inclusion Criteria: First-degree female relatives of histologically diagnosed BC patients in the study sites Women aged 20 to 75 years of age Willingness to be contacted after six months for follow-up Exclusion Criteria: Personal history of BC Previous exposure to breast cancer risk assessment and counselling Absence of intact breasts