A series of educational resources have been produced in a collaboration with patients and between the AHSN Network, Health Education England eLearning for healthcare (HEE elfh), the Royal College of General Practitioners (RCGP) and the Royal College of Surgeons of England, to increase awareness of breast cancer prevention, for both patients and clinicians, by improving and increasing the use of educational resources within this field.

The widely used independent provider of evidence-based GP education Red Whale has produced materials on behalf of the project, in both PDF and short video formats. The concern remains that preventative medication for familial breast cancer is still not widely accessed.

Additionally, as part of this work, changes have also been made to the NICE guidance on familial breast cancer which recommends the use of a range of medications and drugs in the prevention of breast cancer for women who are at high risk due to their family history, and that support optimum pathways for patients.

Health Innovation Manchester (the AHSN for Greater Manchester) led on this work on behalf of the national AHSN Network after receiving an educational grant for the production of the educational resources, which includes a Health Education England eLearning module, a podcast produced by the RCGP, a screencast written by Dr Toni Hazell, General Practitioner and eLearning Development Fellow at the Royal College of General Practitioners (RCGP) and a second podcast produced by the Royal College of Surgeons of England.

The Health Education England eLearning for healthcare (HEE elfh) module is aimed at primary care staff including GPs, nurses, pharmacists, and allied health professionals. This resource outlines the lifestyle and pharmacological interventions that can be used in the primary prevention of breast cancer for pre and postmenopausal women.

It also covers the side effects of each drug and the guidelines to receive treatment. The programme features one module, which takes approximately 20 minutes to complete.

The first podcast, produced by the Royal College of General Practitioners (RCGP), with both Dr Toni Hazell and Dr Nicola Weaver, General Practitioner and Macmillan GP Clinical Cancer Lead Southwark, analyses the evidence behind the use of the medications and drugs, as well as the selection process for referrals, these pathways, and the practicalities of prescribing.

Dr Nicola Weaver, General Practitioner and Macmillan GP Clinical Cancer Lead Southwark, said:

“Breast cancer is the most common cancer with incidence increasing, and this does result in significant physical, psychological and a financial burden, both for the women who are effected and the health services that treat them.

“Several large-scale, randomised and placebo-controlled trials have been conducted and have demonstrated that taking Tamoxifen for five years can reduce the risk of developing cancer by about 40% in women who are at moderate or high risk.”

The second podcast produced by the Royal College of Surgeons of England with Health Innovation Manchester, focusses on ‘Drug Treatments for Breast Cancer Prevention’ featuring a panel consisting of Breast Surgeon Ms Rosie Stanton, Macmillan GP Clinical Cancer Lead Dr Nicola Weaver, Dr Sacha Howell, Medical Oncologist and Senior Lecturer at the University of Manchester, and Dr Gareth Evans, Professor of Medical Genetics and Cancer Epidemiology at the University of Manchester.

This podcast aims to give surgeons and other health care professionals an overview of the treatments available, how they work and which groups of patients would most benefit from them.

Dr Sacha Howell, Senior Lecturer and Honorary Consultant at The Christie NHS Foundation Trust, said:

“This work is the start of a programme that we hope will significantly increase women’s access to preventive medication with tamoxifen, anastrozole and raloxifene. These drugs reduce the incidence of breast cancer by up to 50% and in the case of anastrozole are cost saving to the NHS. Ongoing work will optimise support for women before and after their decision to take preventive medication and those prescribing the treatments in primary care.”

Professor Gareth Evans, Professor in Medical Genetics and Cancer Epidemiology, said:

“The new changes in NICE guidance opens the way to massively expand the proportion of women eligible for NICE approved risk reducing medication from as little as 2% who currently come forward with a designated family history to 10-20% of the population.”

Cath Barrow, Senior Programme Development Lead, Delivery & Development Team at Health Innovation Manchester, said:

“This has been one of the most rewarding projects to work on with fantastic and passionate healthcare professionals who are dedicated to raising awareness through education on the importance of breast cancer prevention. Education plays such an important part in supporting who may be at risk of breast cancer and the resources produced will hopefully provide the opportunity for patients and clinicians to discuss this important topic more openly.”

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