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Impact of Genetic Testing on Risk-Management Behavior of Black Breast Cancer Survivors: A Longitudinal, Observational Study.
- Source :
-
Annals of surgical oncology [Ann Surg Oncol] 2020 May; Vol. 27 (5), pp. 1659-1670. Date of Electronic Publication: 2019 Nov 01. - Publication Year :
- 2020
-
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.<br />Methods: Black women (nā=ā143) 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).<br />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.<br />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.
- Subjects :
- Adult
Black or African American statistics & numerical data
Breast Neoplasms genetics
Breast Neoplasms mortality
CA-125 Antigen
Cancer Survivors
Female
Genes, BRCA1
Genes, BRCA2
Genetic Predisposition to Disease
Humans
Logistic Models
Longitudinal Studies
Magnetic Resonance Imaging
Middle Aged
Mutation
Ovarian Neoplasms genetics
Risk Assessment
United States epidemiology
Breast Neoplasms ethnology
Genetic Testing statistics & numerical data
Mastectomy statistics & numerical data
Ovarian Neoplasms ethnology
Ovarian Neoplasms prevention & control
Salpingo-oophorectomy statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1534-4681
- Volume :
- 27
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Annals of surgical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 31677107
- Full Text :
- https://doi.org/10.1245/s10434-019-07982-9