Additional knowledge of breast cancer risk factors has meant that we are currently exploring risk-based screening, i.e. determining screening strategies based on women’s varying levels of risk. This also enables risk management through primary prevention strategies, e.g. lifestyle programme or risk-reducing medication. However, future implementation of risk-based screening and prevention will warrant significant changes in current practice and policy. In collaboration with researchers in the Netherlands (Radboud university medical center; Dutch Expert Center for Screening), and UK (Manchester University NHS Foundation Trust), the Karma group investigates women’s, and health professionals, perceptions of risk prediction , prevention and risk based screening. This to map organisational needs and preferences to ultimately optimise future acceptability and uptake. The study was conducted during 2017-2019.