Thank you.
It's important to note that a primary care provider can engage in shared decision-making with a woman without knowing the exact lifetime risk she has. That being said, it is important for a family doctor to assess a woman's risk factors—I agree with all the other experts here—because that primary care provider needs to know if that woman is even at an average risk. If she's at an average risk, these guidelines apply to her, and the guidelines say she should have a choice.
If the woman is at a higher than average risk, there is a completely separate screening recommendation that doesn't even fit within these guidelines. It is correct that some primary care physicians could use extra support in learning about risk factors and calculating lifetime risk, and separately, that is outside of the scope of these guidelines. Some of the work I do is in helping to create tool kits and support primary care providers to do this.
I think first and foremost, the most important thing is that one can still have a shared care discussion if one has determined that the woman is of average or slightly above average risk, which the task force clearly defines in these updated guidelines, and which is an improvement from the 2018 guidelines.