Claire C Conley1, Monica L Kasting2, Bianca M Augusto1, Jennifer D Garcia1, Deborah Cragun3, Brian D Gonzalez1, Jongphil Kim4, Kimlin Tam Ashing5, Cheryl L Knott6, Chanita Hughes-Halbert7, Tuya Pal8, Susan T Vadaparampil9. 1. Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA. 2. Department of Health and Kinesiology, Purdue University, West Lafayette, IN, USA. 3. College of Public Health, University of South Florida, Tampa, FL, USA. 4. Division of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center, Tampa, FL, USA. 5. Department of Population Sciences, City of Hope National Medical Center, Duarte, CA, USA. 6. School of Public Health, University of Maryland, College Park, MD, USA. 7. Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA. 8. Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA. 9. Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA. susan.vadaparampil@moffitt.org.
Abstract
BACKGROUND: Black women are overrepresented among premenopausal breast cancer (BC) survivors. These patients warrant genetic testing (GT) followed by risk-reducing behaviors. This study documented patterns and predictors of cancer risk-management behaviors among young black BC survivors after GT. METHODS: Black women (n = 143) with a diagnosis of BC at the age of 50 years or younger received GT. At 1 year after GT, participants reported receipt of risk-reducing mastectomy, risk-reducing salpingo-oophorectomy, mammogram, breast magnetic resonance imaging (MRI), CA125 test, and transvaginal/pelvic ultrasound. Logistic regression was used to examine predictors of BC risk management (risk-reducing mastectomy or breast MRI) and ovarian cancer risk management (risk-reducing salpingo-oophorectomy, CA125 test, or transvaginal/pelvic ultrasound). RESULTS: Of the study participants, 16 (11%) were BRCA1/2-positive, 43 (30%) had a variant of uncertain significance, and 84 (59%) were negative. During the 12 months after GT, no women received risk-reducing mastectomy. The majority (93%) received a mammogram, and a smaller proportion received breast MRI (33%), risk-reducing salpingo-oophorectomy (10%), CA125 test (11%), or transvaginal/pelvic ultrasound (34%). Longer time since the BC diagnosis predicted lower likelihood of BC risk management (odds ratio [OR] 0.54). BRCA1/2 carrier status (OR 4.57), greater perceived risk of recurrence (OR 8.03), and more hereditary breast and ovarian cancer knowledge (OR 1.37) predicted greater likelihood of ovarian cancer risk management. CONCLUSIONS: Young black BC survivors appropriately received mammograms and ovarian cancer risk management based on their BRCA1/2 test result. However, the low usage of MRI among BRCA1/2 carriers contrasts with national guidelines. Future research should examine barriers to MRI among black BC survivors. Finally, modifiable variables predicting risk management after GT were identified, providing implications for future interventions.
BACKGROUND: Black women are overrepresented among premenopausal breast cancer (BC) survivors. These patients warrant genetic testing (GT) followed by risk-reducing behaviors. This study documented patterns and predictors of cancer risk-management behaviors among young black BC survivors after GT. METHODS: Black women (n = 143) with a diagnosis of BC at the age of 50 years or younger received GT. At 1 year after GT, participants reported receipt of risk-reducing mastectomy, risk-reducing salpingo-oophorectomy, mammogram, breast magnetic resonance imaging (MRI), CA125 test, and transvaginal/pelvic ultrasound. Logistic regression was used to examine predictors of BC risk management (risk-reducing mastectomy or breast MRI) and ovarian cancer risk management (risk-reducing salpingo-oophorectomy, CA125 test, or transvaginal/pelvic ultrasound). RESULTS: Of the study participants, 16 (11%) were BRCA1/2-positive, 43 (30%) had a variant of uncertain significance, and 84 (59%) were negative. During the 12 months after GT, no women received risk-reducing mastectomy. The majority (93%) received a mammogram, and a smaller proportion received breast MRI (33%), risk-reducing salpingo-oophorectomy (10%), CA125 test (11%), or transvaginal/pelvic ultrasound (34%). Longer time since the BC diagnosis predicted lower likelihood of BC risk management (odds ratio [OR] 0.54). BRCA1/2 carrier status (OR 4.57), greater perceived risk of recurrence (OR 8.03), and more hereditary breast and ovarian cancer knowledge (OR 1.37) predicted greater likelihood of ovarian cancer risk management. CONCLUSIONS: Young black BC survivors appropriately received mammograms and ovarian cancer risk management based on their BRCA1/2 test result. However, the low usage of MRI among BRCA1/2 carriers contrasts with national guidelines. Future research should examine barriers to MRI among black BC survivors. Finally, modifiable variables predicting risk management after GT were identified, providing implications for future interventions.
Authors: Marc D Schwartz; Claudine Isaacs; Kristi D Graves; Elizabeth Poggi; Beth N Peshkin; Christy Gell; Clinton Finch; Scott Kelly; Kathryn L Taylor; Lauren Perley Journal: Cancer Date: 2011-06-29 Impact factor: 6.860
Authors: Tiffany A Edwards; Hayley S Thompson; Naa Oyo A Kwate; Karen Brown; Margaret M McGovern; Andrea Forman; Nidhi Kapil-Pair; Lina Jandorf; Dana H Bovbjerg; Heiddis B Valdimarsdottir Journal: Patient Educ Couns Date: 2008-05-13
Authors: Kelly A Metcalfe; Jan Lubinski; Parviz Ghadirian; Henry Lynch; Charmaine Kim-Sing; Eitan Friedman; William D Foulkes; Susan Domchek; Peter Ainsworth; Claudine Isaacs; Nadine Tung; Jacek Gronwald; Shelly Cummings; Teresa Wagner; Siranoush Manoukian; Pål Møller; Jeffrey Weitzel; Ping Sun; Steven A Narod Journal: J Clin Oncol Date: 2008-01-14 Impact factor: 44.544
Authors: Tara M Friebel; Susan M Domchek; Susan L Neuhausen; Theresa Wagner; D Gareth Evans; Claudine Isaacs; Judy E Garber; Mary B Daly; Rosalind Eeles; Ellen Matloff; Gail Tomlinson; Henry T Lynch; Nadine Tung; Joanne L Blum; Jeffrey Weitzel; Wendy S Rubinstein; Patricia A Ganz; Fergus Couch; Timothy R Rebbeck Journal: Clin Breast Cancer Date: 2007-12 Impact factor: 3.225
Authors: Angela R Bradbury; Comfort N Ibe; James J Dignam; Shelly A Cummings; Marion Verp; Melody A White; Grazia Artioli; Laura Dudlicek; Olufunmilayo I Olopade Journal: Genet Med Date: 2008-03 Impact factor: 8.822