Background/Aims: Women who are BRCA1 or BRCA2 mutation carriers, or have relatives diagnosed with breast cancer, are classified as being at increased risk of breast cancer. However, clinically calculated risk estimates do not align with women’s personal risk appraisals due to difficulties in understanding the numerical presentations, leading to low trust and inaccurate preventive health behaviours. This study synthesises and explores existing evidence on the understanding of risk perception and appraisal among women at increased risk of breast cancer to improve risk communication and risk-reducing strategies.
Methods: A scoping review followed the Jonna Briggs Institute (JBI) methodological guidelines and was registered a priori in Open Science Framework (OSF). The literature search was conducted in electronic databases (PubMed, MEDLINE (Ovid), CINAHL, PsycINFO, and Scopus), and 22 studies were included. Qualitative or mixed-method studies with sufficient qualitative data were included if the studies involved adult women who have identified as being at increased risk of breast cancer and explored how women perceive and appraise their risk. Data will be thematically synthesised.
Results: Emerging findings suggest that women’s understandings of risk are developed from several factors, including family cancer experiences, genetic susceptibility and psychological responses. Risk appraisal is influenced by comparisons with affected relatives, lifestyle behaviours and emotional responses, contributing to women’s risk-reducing decision-making and screening behaviours. Themes are undergoing finalisation.
Conclusions: This review will provide an updated summary of how women who have been at increased risk of breast cancer view and appraise their risk, map existing evidence in this area, and identify components that contribute to future research, better risk communication, and interventions that support informed decision-making. Findings will contribute to awareness and screening initiatives to identify psychological constructs that may act as barriers to protective detection and treatment behaviours.