Abstract
BACKGROUND: Breast cancer (BC) is the most common cancer among women. Promoting healthy lifestyle behaviours at the population level has the potential to prevent a substantial proportion of cases. Preventive interventions should be grounded in the target population’s existing beliefs and perceptions. Therefore, this study aimed to explore women’s perceptions of BC, their attitudes toward engaging in preventive behaviours, and their needs for risk information. METHODS: Semi-structured individual interviews were conducted during spring 2025, with 16 Swedish women, aged 24–68. The interview guide was informed by The Common-Sense Model of Self-Regulation. The data were inductively analysed using thematic analysis. RESULTS: Four themes were developed. (I) Experience and representation shape women´s emotional and cognitive preunderstanding: Women had clear perceptions of the consequences of BC but were largely uninformed about BC causes. They struggled to envision how lifestyle factors could influence BC risk, due to knowledge gaps about underlying mechanisms and because it did not correspond with the affected women they knew. (II) Self-perceived risk: a mix of feelings and compensating reasoning: Women had difficulties assessing their own risk due to uncertainty about whether their lifestyle was healthy enough and some acknowledged that their logical reasoning was overshadowed by their emotions. (III) Willingness to change lifestyle: it is more than reduced risk of breast cancer: Efforts to pursue a healthy lifestyle were mostly guided by its impacts on present wellbeing. (IV) Constructing uplifting messages that reach and teach without blame: Current information in society was perceived as too general. The women therefore requested more actionable and uplifting messages educating them about why something poses a risk factor. CONCLUSION: The study found that women primarily learned about the impact of BC on patients’ lives through media stories, which often evoked fear and sadness. Perceived preventive actions were largely limited to early detection through self-examination and participation in screening programs. However, there were knowledge gaps regarding BC causes that current information in society fails to address. To guide women’s health decisions, risk communication should prioritize evidence-based explanations of how risk factors influence BC risk, rather than relying primarily on personal narratives. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-026-27291-7.