PIONEER Study of Lifestyle Intervention to Reduced Breast Cancer Risk (PIONEER)

A randomised controlled trial in which women discharged from the symptomatic breast clinic, who are above population risk (according to Tyrer Cuzick) will be asked to create lifestyle related goals. They will be told their estimated risk of developing breast cancer and will be randomised to one of three interventions: Breast cancer risk leaflet only lifestyle website lifestyle website plus group coaching. Fifty per cent of women will also be randomised to have Single Nucleotide Polymorphisms (SNPs) performed, and these will be incorporated into their risk score. The primary end point will be whether or not women achieve their lifestyle goal.

Women will be educated about lifestyle factors which increase breast cancer risk. They will also be guided through an online goal setting process.

Whether women have achieved their lifestyle goals. Proportion answering "yes" to a binary question: Did you achieve the goal you set? Compared between the three arms.

To assess the acceptability of women to find out their personalised breast cancer risk and to commit to making a change in a modifiable risk factor

Measured when the final participant has completed 12 months in the study, estimated 15 months from start date

Measured when the final participant has completed 12 months in the study estimated 15 months from start date

Measured when the final participant has completed 12 months in the study estimated 15 months from start date

Change in Cancer Worry Scale (Revised) score from 0 to 3 months. Cancer Worry score is measured between 8 and 32 with 32 being the highest level of anxiety.

Measured when the final participant has completed 12 months in the study estimated 15 months from start date

To identify whether there is an association between initial Cancer Worry Scale (Revised) score and change in behavioural risk factors

Cancer Worry score compared with goal achievement. Cancer Worry score is between 8 and 32 with 32 being the highest level of anxiety.

Measured when the final participant has completed 12 months in the study estimated 15 months from start date

Measured when the final participant has completed 12 months in the study estimated 15 months from start date

To assess the impact of the different interventions on uptake and adherence to chemoprevention at 1 year

Measured when the final participant has completed 12 months in the study estimated 15 months from start date

Administration time required for each group; Average goal achievement compared to average cost of each intervention.

Measured when the final participant has completed 12 months in the study estimated 15 months from start date

Inclusion Criteria: Female Aged between 30 and 60 years Attending the symptomatic breast clinic at RMH Sutton or Chelsea OR the family history clinics at RMH Sutton or Chelsea, or has heard about the study through other means such as (but not limited to), friends who have been diagnosed with cancer, friends who are already taking part in the PIONEER study, social media, mainstream media, fliers through the doors of houses in the area of RMH. Benign or B3 diagnosis if participant has attended clinic Agree to receive their personalised breast cancer risk Available to participate in a 1 year risk prevention programme Able to attend the Royal Marsden for a blood test if randomised to this group Exclusion Criteria: Malignant Diagnosis Does not want to find out personalised breast cancer risk Not available to participate for the full year NOTE: after risk assessment, women who have a breast cancer risk lower than that of population level will be excluded from participating in the behavioural change elements.