Table 3.

Enablers to the discussion of chemoprevention in Family Cancer Centres with supporting quotes

EVIDENCE	Participant	No	Quote
'Reasonable' evidence in BRCA2 carriers	5C (med oncologist)	17	I think that in a BRCA2 mutation carrier we'll discuss Tamoxifen- I'm a bit more confident about Tamoxifen with a BRCA2, than in a BRCA1.
Side-effects less in younger women	1A (med oncologist)	18	...side effects at that age [45] are likely be to be small in absolute terms
PRACTICE
Enroling people on a trial is convenient	1B (med oncologist)	19	When the IBIS I study was recruiting that would be definitely part of my discussion because there was a study that they could participate in to try and get an answer. But then that closed so there's been a window between now and then [-]... There's sort of been a bit of a lull.
Not expensive	5C (med oncologist)	20	identified that not being PBS-listed was not a constraint to prescribing Tamoxifen because it 'is not an expensive drug'
PERCEPTION
Action of Tamoxifen to reduce risk 'intuitively makes sense'	5C (med oncologist)	21	But intuitively, I can understand how um, Tamoxifen would reduce the risk.
Lack of 'hard data' is not always a barrier to recommending something 5C (med oncologist)	5A (clinical geneticist)	22	5A Breast ultrasound? If you're having MRI? No, but if you aren't having it, then, there's very little hard data... 5C I know there's no hard data but that's never stopped anyone doing anything