ASPO Abstracts
Impact of Genetic Testing on Risk Management in Black Breast Cancer Survivors
Category: Cancer Health Disparities
Conference Year: 2019
Abstract Body:
Purpose of the Study: National Comprehensive Cancer Network guidelines suggest all breast cancer survivors have annual mammograms; BRCA1/2 carriers should also have breast MRI, and consider risk-reducing mastectomy and/or risk-reducing oophorectomy. This study assesses whether BRCA1/2 testing impacted cancer risk management behaviors among young Black breast cancer survivors.Methods: Participants (N=148) were Black women with invasive breast cancer diagnosed age ≤50 years from 2009-2012. Women received genetic testing through a prospective study. At 1 year post-genetic testing, participants reported receipt of risk-reducing mastectomy, risk-reducing oophorectomy, mammogram, and breast MRI in the last year. Chi-square analyses examined whether a positive BRCA1/2 test result was related to use of these risk reduction strategies in the year post-genetic testing. Analyses examining risk-reducing mastectomy, mammogram, and breast MRI included only women with at-risk breast tissue pre-genetic testing (n=98). Similarly, risk-reducing oophorectomy analyses included only women with ovaries pre-genetic testing (n=140).Results: Participants were 45 (±6) years of age. Most had ≥high school education (83%) and medical insurance (84%). Seventeen (12%) were BRCA1/2 positive, 46 (31%) had a variant of uncertain significance, and 85 (57%) were negative. BRCA1/2 status was related to receipt of risk-reducing oophorectomy (31% positive v. 10% negative/variant of uncertain significance; p=0.01). BRCA1/2 status was unrelated to receipt of risk-reducing mastectomy (0% positive v. 2% negative/variant of uncertain significance; p=0.63), mammogram (90% positive v. 93% negative/variant of uncertain significance; p=0.71), or breast MRI (30% positive v. 33% negative/variant of uncertain significance; p=0.85).Conclusions: Young Black breast cancer survivors appropriately received risk-reducing oophorectomy and mammogram based on BRCA1/2 test result. However, BRCA1/2 test result did not predict receipt of breast MRI. The low usage of breast MRI among BRCA1/2 positive women directly contrasts with national screening guidelines. Future research should examine barriers to supplemental breast MRI recommendation and access among Black breast cancer survivors following genetic testing.
Keywords: breast cancer; risk management; genetic testing