BRCA1/2 in High-Risk African American Women with Breast Cancer: Providing Genetic Testing through Various Recruitment Strategies

2008 ◽  
Vol 12 (3) ◽  
pp. 401-407 ◽  
Author(s):  
Tuya Pal ◽  
Susan Vadaparampil ◽  
Judy Betts ◽  
Cheryl Miree ◽  
Song Li ◽  
...  
Keyword(s):  
Breast Cancer ◽  
African American ◽  
Genetic Testing ◽  
High Risk ◽  
African American Women ◽  
Recruitment Strategies ◽  
American Women

scholarly journals Factors Influencing Breast Cancer Genetic Testing Among High Risk African American Women: A Systematic Review

2019 ◽  
Author(s):  
Shirley Spencer ◽  
Carolyn Rodgers ◽  
Vickii Coffey
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
African American ◽  
Genetic Testing ◽  
High Risk ◽  
African American Women ◽  
Integrative Model ◽  
Cancer Genetic ◽  
American Women

African American women are disproportionately impacted by breast cancer and its associated effects. They have the highest breast cancer mortality rate of all racial and ethnic groups in the U.S., yet, many high risk African American women do not follow-up with genetic testing despite, having a shorter survival rate and more likely to develop malignancies or aggressive forms of breast cancer than white women. Purpose: This review explored breast cancer genetic follow up and barriers among African American women and made recommendations for designing tailored high risk breast cancer programs. Method: The Integrative Model of Behavioral Prediction framework provided the framework for the review. PubMed, PSYINFO, CINAHL and Cochrane Collection Plus databases were searched for articles published from 2007 to 2017 that focused on attitude and beliefs that influenced genetic testing follow up among African American women. Three reviewers independently reviewed and appraised articles. The quality of the articles was assessed to determine the evidence level and overall recommendations using the Joanna Bridge Institute grading criteria. Results: Sixteen of the 2275 articles reviewed met the inclusion criteria of which, seven showed statistically significance changes related to family concerns, medical mistrust and cost barriers; decreases in breast cancer worry and perceived risk after genetic counseling; and higher education level and diagnosed early increased genetic testing. Conclusions: This systematic review provides greater understanding of how the social determinants of health influence decisions about genetic testing and treatment to determine why African American women who are at risk for breast cancer, do not progress to genetic testing. It provided recommendations for designing sensitive curriculum content for African American women and providers to increase genetic follow-up and reduce breast cancer disparity. The results of this review could be used to design comprehensive, tailored interventions to address the identified barriers, increase breast cancer awareness and early detection, and help minority women make informed, value decisions about genetic testing and treatment options. Recommendations: Future research is required to examine the role communities, agencies and policy makers play in improving clinical outcomes for minorities.

Increased Uptake of BRCA1/2 Genetic Testing Among African American Women With a Recent Diagnosis of Breast Cancer

2008 ◽  
Vol 26 (1) ◽  
pp. 32-36 ◽  
Author(s):  
Lisa R. Susswein ◽  
Cécile Skrzynia ◽  
Leslie A. Lange ◽  
Jessica K. Booker ◽  
Mark L. Graham ◽  
...  
Keyword(s):  
Breast Cancer ◽  
African American ◽  
Genetic Testing ◽  
African American Women ◽  
White Women ◽  
Breast Cancer Diagnosis ◽  
American Women ◽  
Logistic Regression Models ◽  
Testing Uptake ◽  
Recent Diagnosis

Purpose Studies suggest that African American women are less likely to pursue BRCA1/2 genetic testing than white women. However, such studies are often confounded by unequal access to care. Methods Data from 132 African American and 636 white women, obtained from a clinical database at the University of North Carolina (Chapel Hill, NC) between 1998 and 2005, were analyzed to assess BRCA1/2 genetic testing uptake. Importantly, the clinical setting minimized barriers of both cost and access. Race and time of new breast cancer diagnosis (recent v > 1 year before genetic evaluation) were assessed for association with BRCA1/2 testing uptake using multivariable logistic regression models. Results Both race (P = .0082) and a recent diagnosis of breast cancer (P = .014) were independently associated with testing uptake. African American women had a lower estimated odds of pursuing testing than white women (odds ratio [OR], 0.54; 95%CI, 0.34 to 0.85), and women with a recent diagnosis had a higher OR than those with a remote diagnosis (OR, 1.58; 95% CI, 1.10 to 2.29). In a race-stratified analysis, there was no statistical evidence for association between recent status and testing uptake in the larger white stratum (OR, 1.38, P = .13) while there was for the smaller African American sample (OR, 2.77, P = .018). The test of interaction between race and remote status was not significant (P = .15). Conclusion African American race was associated with an overall decreased uptake of BRCA1/2 genetic testing, even when barriers of ascertainment and cost were minimized. However, among African American women, a recent diagnosis of breast cancer was associated with substantially increased uptake of testing.

scholarly journals Attitudes about genetic testing and genetic testing intentions in African American women at increased risk for hereditary breast cancer

2005 ◽  
Vol 7 (4) ◽  
pp. 230-238 ◽  
Author(s):  
Lisa Kessler ◽  
Aliya Collier ◽  
Kiyona Brewster ◽  
Chachira Smith ◽  
Benita Weathers ◽  
...  
Keyword(s):  
Breast Cancer ◽  
African American ◽  
Genetic Testing ◽  
African American Women ◽  
Hereditary Breast Cancer ◽  
American Women ◽  
Increased Risk

Screening Behaviors Among African American Women at High Risk for Breast Cancer: Do Beliefs About God Matter?

2002 ◽  
Vol 29 (5) ◽  
pp. 835-843 ◽  
Author(s):  
Anita Yeomans Kinney ◽  
Gwyn Emery ◽  
William N. Dudley ◽  
Robert T. Croyle
Keyword(s):  
Breast Cancer ◽  
African American ◽  
High Risk ◽  
African American Women ◽  
American Women ◽  
Screening Behaviors

scholarly journals An exercise trial targeting African-American women with metabolic syndrome and at high risk for breast cancer: Rationale, design, and methods

2015 ◽  
Vol 43 ◽  
pp. 33-38 ◽  
Author(s):  
Chiranjeev Dash ◽  
Kepher Makambi ◽  
Sherrie F. Wallington ◽  
Vanessa Sheppard ◽  
Teletia R. Taylor ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metabolic Syndrome ◽  
African American ◽  
High Risk ◽  
African American Women ◽  
American Women ◽  
Design And Methods

Genomic profiling of breast cancer in African-American women.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 11054-11054
Author(s):  
Raquel Nunes ◽  
Lynette Wray ◽  
Mihriye Mete ◽  
Thomas Godwin ◽  
Pia Maarit Herbolsheimer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Gene Expression ◽  
African American ◽  
High Risk ◽  
African American Women ◽  
Triple Negative ◽  
Stage I ◽  
Mrna Levels ◽  
American Women ◽  
Basal Type

11054 Background: Molecular profiling of breast cancer (BC) identifies intrinsic subtypes with distinct gene expression and clinical characteristics. In the US, BC is less frequent in African-American females (AAF); however mortality is higher, particularly among younger women. Unfavorable subtypes of BC seem to be more frequent in premenopausal AAF. Methods: Tumor gene expression in AAF presenting with early stage or locally advanced BC was performed using the Symphony platform on fresh and paraffin-embedded tissue (Agendia inc), a microarray-based method which classifies tumors according to prognosis (MammaPrint, MP), molecular subtype (BluePrint, BP) and estrogen receptor (ER), progesterone receptor (PR) and Human Epidermal Growth Factor Receptor 2 (HER2) mRNA levels (TargetPrint, TP). Genomic information is correlated with clinical and pathologic characteristics and Oncotype DX recurrence score (RS) when available. We plan to enroll 100 patients. Results: Results available in 46 patients. Median age 62 years (range 24-100), 20 stage I, 15 stage II, 11 stage III disease. There was no significant association between MP risk and stage, but MP risk was significantly associated with grade 3 disease (p=.006). 9 cancers were triple negative by IHC; using BP, 8 of these were Basal-type and 1 HER2-type. Basal-type was the most common subtype in patients ≤ 40 years old (p < .001). In the 6 cases ER positive by IHC but negative by TP, 3 were Basal-type and 3 were HER2-type.14 patients had Oncotype RS results available: 2 were High Risk by Oncotype and MP; 3 had intermediate RS, 2 of which were High Risk by MP; 9 had a low RS, 4 of which were High Risk by MP. Conclusions: African-American women with stage I to III BC often present with High-Risk disease irrespective of stage. BP classified all young patients (≤40) as Basal-type. Molecular subtyping confirmed the biologic heterogeneity in triple negative and hormone positive tumors. Oncotype RS and MP offered different prognostic information. Follow up will be needed to determine correlation with outcome. Funding: MP, BP and TP test provided by Agendia. Biostatistical support by GHUTTCS-CTSA. [Table: see text]

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