Jessica Audrienna’s scientific contributions

A breast cancer risk assessment tool for Asian populations, incorporating Polygenic Risk Score and Gail Model algorithm, has been established and validated. However, effective methods for delivering personalized risk information remain underexplored. This study aims to identify and develop effective methods for conveying breast cancer risk information to Asian women. Through ten focus group discussions with 32 women in Indonesia and Singapore, we explored preferences for the presentation of risk information. Participants favored comprehensive reports featuring actionable steps, simplified language, non-intimidating visuals, and personalized risk reduction recommendations. Singaporean participants, more aware of breast cancer prevention, showed a lower likelihood of seeking follow-ups upon receiving low-risk results compared to Indonesians. Overall, participants found the reports useful and advocated for similar approaches in other disease assessments. Balancing content and complexity in reports is crucial, highlighting the need for improved patient understanding and engagement with healthcare providers. Future studies could explore physicians’ roles in delivering personalized risk assessments for breast cancer prevention.

Breast cancer remains a significant concern worldwide, with a rising incidence in Indonesia. This study aims to evaluate the applicability of risk-based screening approaches in the Indonesian demographic through a case-control study involving 305 women. We developed a personalized breast cancer risk assessment workflow that integrates multiple risk factors, including clinical (Gail) and polygenic (Mavaddat) risk predictions, into a consolidated risk category. By evaluating the area under the receiver operating characteristic curve (AUC) of each single-factor risk model, we demonstrate that they retain their predictive accuracy in the Indonesian context (AUC for clinical risk: 0.6744; AUC for genetic risk: 0.6742). Notably, our combined risk approach enhanced the AUC to 0.7015, highlighting the advantages of a multifaceted model. Our findings demonstrate for the first time the applicability of the Mavaddat and Gail models to Indonesian populations, and show that within this demographic, combined risk models provide a superior predictive framework compared to single-factor approaches.

Introduction: A breast cancer risk assessment tool using Polygenic Risk Score (PRS) assessment of 313 single nucleotide polymorphisms and a risk prediction algorithm from the Gail Model had been established and validated for Asian population. Through facilitated focus group discussions, we assessed the preferences of women from two Asian countries regarding the presentation of risk results, the level of detail provided for explanations, and recommendations for follow-up actions. Methods: This qualitative study was conducted between July to October 2022 with Asian women above the age of 25. We structured a focus group discussion to evaluate the views and perceptions of women in Indonesia and Singapore in relation to personalized breast cancer risk assessment. All participants received either a detailed high-risk or low-risk mock report and were assigned to either high-risk result or low-risk result focus group based on the report they had randomly received. All focus group discussion content was then thematically analyzed. Results: In Singapore, participants preferred a detailed report as it was comprehensive and provided follow-up steps and information to manage their breast cancer risk. Participants raised the need for visuals without colors that project intimidation as well as a summary on the first page of the report to support interpretations. Regarding content, participants expected recommended actions to reduce their risk. Communication styles could also be improved with simplified language. Furthermore, we identified anxious responses from participants receiving high-risk results and relieved responses from those receiving low-risk results. Overall, participants found the report useful and would like to see similar reports on other diseases in the future. Conclusion: Overall, most patients prefer a test report to be well balanced between content and complexity. The study also highlighted the importance of psychological impact of patients receiving their test reports, which is greatly influenced by the patients' degree of understanding and interpretation of the reports. Finally, as most patients would likely increase their engagement with their physicians upon receiving their test results, future studies could be extended to physicians who are directly involved in the patient care delivery of breast cancer prevention.