The study reviewed here found that African American women not diagnosed with breast cancer were 49% less likely than white women to get genetic testing for BRCA1 or BRCA2 gene abnormalities recommended by their doctor. But African American women who were diagnosed with breast cancer chose genetic testing as often as white women. The genetic testing was recommended because of the women's personal and family medical history.
In this study, about half of the African American women who didn't get genetic testing didn't have the testing because they didn't have health insurance or their health insurance didn't cover the testing. Genetic tests can be expensive -- costs range from $300 to $3,000 -- which can affect someone's decision to have the test, even if it's recommended.
On average, African American women have about the same risk of having an abnormal BRCA1 or BRCA2 gene as white women. But research continues to show that non-white women are less likely than white women to have genetic testing.
The risk of having an abnormal BRCA1 or BRCA2 gene is higher in women diagnosed with breast cancer who:
Abnormal BRCA1 and BRCA2 genes account for about 10% of all breast cancers. Women who have an abnormal BRCA1 or BRCA2 gene have up to an 85% risk of developing breast cancer by age 70. Their risk for ovarian cancer is also higher.
It's important to get breast cancer genetic testing if a doctor or genetic counselor recommends it based on your personal and family medical history. If the test reveals that you have an abnormal gene, work with your doctor to do everything you can to manage your increased risk, including:
No matter your race or ethnicity, your doctor should consider your unique situation and individual risk of having an abnormal breast cancer gene and help you decide whether you should receive genetic counseling and testing. If testing is recommended, don't let cost stand in the way. Talk to your doctor or someone else involved in your care about options for being tested that might reduce the financial burden.
Visit the breastcancer.org Genetics and Breast Cancer Risk section to learn more about breast cancer genes, assessing your genetic risk, and deciding whether breast cancer gene testing makes sense for YOU.
NEW YORK (Reuters Health) - African American women are generally less likely than white women to pursue genetic testing for BRCA1 or BRCA2, the gene mutations associated with an increased risk of break cancer, researchers report. However, African American women with a recent diagnosis of breast cancer are much more likely to do so, according to the article in the Journal of Clinical Oncology.
"Everybody deserves consideration for testing if their clinical and family history situation warrant it," Dr. James P. Evans, from the University of North Carolina at Chapel Hill, told Reuters Health. "Regardless of race, one has to approach genetic testing as an important option and explain the pros and cons to the patient."
Evans and associates examined race and the timing of breast cancer diagnosis and the frequency of BRCA1/2 genetic testing among women attending the UNC Cancer Genetics Service.
Among 768 women diagnosed with breast cancer who were offered BRCA1/2 testing, the rates of testing among African American and white patients did not differ, authors report.
Overall, African American women were 46 percent less likely than white women to undergo BRCA1/2 genetic testing, the author report.
Women who were diagnosed recently had a higher odds of pursuing testing than did women diagnosed more than 1 year before genetic evaluation, the investigators say, but this difference was statistically significant only for African American women, who were almost three-times as likely to undergo genetic testing.
Why a recent breast cancer diagnosis increases the use of BRCA1/2 genetic testing so "dramatically" among African American "could contribute to a better understanding of racial disparities in genetic testing and medicine," the authors conclude.
"We continue to aggressively try to find avenues for women who need testing but can't afford it, Evans said."One of the most interesting (and distressing) features of our study in my mind is that almost half of the patients who could benefit from testing can't get it...either because they had no insurance or their insurance was inadequate. Only through our special program were we able to provide it for all those patients."
Maximizing the use of BRCA1/2 testing requires "good genetic counseling and a personalized attentive approach on the side of the medical team," Evans advised. "We try to take a lot of time to explain the nuances to women and why testing can be of help to them and their families. I think this is especially important with African American patients where there is traditionally a lower level of trust in the medical profession (understandably)."
SOURCE: Journal of Clinical Oncology, January 1, 2008.
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