Discussing breast cancer risk in primary care.

Options for managing breast cancer risk now include screening, genetic testing, lifestyle modification, medication, and surgery. A woman's knowledge of her risk factors for breast cancer, her perceptions of that risk, and her concerns about cancer all shape her decisions about cancer screening and prevention. Physicians should involve women patients in making informed screening decisions, while reviewing their health risks and the benefits and risks associated with different courses of action. All women should be involved in this process, with special attention to older socioeconomically disadvantaged women, who are frequently left out of such discussions. Physicians can play a major role in reducing cancer disparities and the corresponding rates of breast cancer morbidity and mortality by keeping current in their knowledge of risk assessment, broadening the range of patients with whom they communicate about risk, and enhancing their communication skills to address diverse patient needs.