Some Young Women with BRCA Mutations Are Less Likely to Receive the Standard of Care
Take-Home Message:
Young black women with BRCA mutations are less likely to receive the standard of care for cancer detection and risk reduction.
Disparities in Cancer Risk Management Among BRCA Carriers Across a Diverse Sample of Young Black, Hispanic, and Non-Hispanic White Breast Cancer Survivors
Authors: Pal, T., et. al.
Source: J Clin Oncol 34, 2016 (suppl; abstr LBA 1504)
meetinglibrary.asco.org/content/170210-176
BRCA mutations increase breast and ovarian cancer risks, among other diseases. It is widely accepted that risk reducing salpingoophorectomy (RRSO — removing the ovaries and Fallopian tubes) and risk reducing mastectomy (RRM) are very effective in disease prevention. MRI (magnetic resonance imaging) screening has been proven to increase breast cancer detection and is considered the standard of care for women who do not undergo RRM.
These investigators reviewed the cases of women diagnosed with breast cancer under 50 years of age in the state of Florida between 2009 and 2012. Over 800 of them tested positive for BRCA mutations. For this subset, the rates of RRSO, RRM and MRI screening were evaluated and compared among black, Hispanic, and Non-Hispanic White (NHW) women.
RRSO was performed in 71% of the NHW patients, compared to 32% of black patients and 83% of Hispanic patients. Screening MRI or RRM were used in 98% of NHW, 85.7% of blacks and 100% of Hispanics. After controlling for variables including income, family history and insurance type, Hispanic and NHW patients were still significantly more likely than black patients to have RRSO and RRM.
The results are concerning because they suggest that some patients meet criteria for therapies that greatly reduce cancer risk, but they are not receiving them. The group concludes that more effort is needed to understand and devise methods to improve cancer risk management for all patient populations.
