ASPO Abstracts
Awareness, Utilization, and Guideline-Adherence to Breast Cancer Risk Management Behavior Among a Community-Based Sample of High-Risk Women
Category: Early Detection & Risk Prediction
Conference Year: 2022
Abstract Body:
Purpose: Clinical guidelines recommend risk-management methods for women with lifetime breast cancer (BC) risk of ‚â•20%. Prior research has mainly explored use of these options among white women with pathogenic BRCA variants or already in specialized high-risk care. Using a more inclusive approach, we aimed to assess awareness, utilization, and guideline adherence of BC risk-management methods among a racially diverse, community-based sample.Methods: We administered an online survey that included measures of risk-management behavior, potential correlates, and information necessary to determine lifetime BC risk. Eligible participants were Black and non-Hispanic white women aged 18-75 years with no prior cancer history and lifetime BC risk ‚â• 20%. Descriptive analyses were used to assess awareness and utilization of mammograms, breast MRIs, prophylactic oophorectomy, prophylactic mastectomy, and chemoprevention, and adherence to National Comprehensive Cancer Network (NCCN) guidelines. Logistic regression was used to assess the associations between BRCA mutation status, race, and health insurance with awareness, utilization, and guideline adherence.Results: A total of 717 high-risk participants (35% Black) completed the survey; 146 (20%) had pathogenic BRCA mutations. Most women were aware of breast MRI (79%) and mastectomy (84%); only 61% had heard of oophorectomy and 39% of chemoprevention. Utilization of risk-management practices was low: 36% had a mammogram and 28% a breast MRI in the last 12 months. Only 10% had used risk-reducing mastectomy, 13% oophorectomy, and 2% chemoprevention. One-third (32%) were fully adherent to screening guidelines for their risk level; 13% were fully adherent to risk-reduction guidelines for their risk level. White women, women with health insurance, and those with pathogenic BRCA mutations had higher odds of awareness, utilization, and guideline-adherence to most risk-management methods compared to their peers.Conclusions: Awareness, utilization, and NCCN guideline-adherence of BC risk management were low among a racially diverse, community-based sample of high-risk women. Studies of barriers, facilitators, and development of interventions are needed to decrease disparities and increase appropriate risk-management behavior.
Keywords: breast cancer risk, risk management, cancer prevention