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Background  Breast cancer is the most common cancer in the UK. Lifestyle factors including excess weight contribute to risk of developing the disease. Whilst the exact links between weight and breast cancer are still emerging, it is imperative to explore how women understand these links and if these beliefs impact on successful behaviour change.    Method  Overweight/obese premenopausal women (aged 35–45) with a family history of breast cancer (lifetime risk 17–40%) were invited to a semi-structured interview following their participation in a 12 month weight loss intervention aimed at reducing their risk of breast cancer. Interviews were carried out with 9 women who successfully achieved ≥5% weight loss and 11 who were unsuccessful. Data were transcribed verbatim and analysed using thematic analysis.    Results  Three themes were developed from the analysis. The first theme  how women construct and understand links between weight and breast cancer risk  is composed of two subthemes,  the construction of weight and breast cancer  risk and  making sense of weight and breast cancer risk . This theme explores women’s understanding of what contributes to breast cancer risk and whether they believe that weight loss could reduce their breast cancer risk. The second theme  motivation and adherence to weight loss interventions  explains that breast cancer risk can be a motivating factor for adherence to a weight loss intervention. The final theme,  acceptance of personal responsibility for health  is composed of two subthemes  responsibility for one’s own health  and  responsibility for family health  through making sensible lifestyle choices.    Conclusion  Beliefs about weight and breast cancer risk were informed by social networks, media reports and personal experiences of significant others diagnosed with breast cancer. Our study has highlighted common doubts, anxieties and questions and the importance of providing a credible rationale for weight control and weight loss which addresses individual concerns. Counselling and health education material should be tailored to facilitate understanding of both genetic and modifiable risk factors and should do more help individuals to visualise the weight and breast cancer link.

Beliefs about weight and breast cancer: an interview study with high risk women following a 12 month weight loss intervention