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Uptake of preventive surgical measures among Latinas with BRCA1/2 mutations

Filipa Lynce, MD, Georgetown University
Study abstract

Deleterious mutations in the BRCA1/2 genes are associated with an increased risk of breast and ovarian cancer. Such mutations confer a 39% to 85% lifetime risk of female breast cancer and an 11% to 62% lifetime risk of ovarian cancer. Germline testing for these genes creates an opportunity to reduce mortality and morbidity by providing appropriate risk reducing and screening options. Evaluation of the efficacy of these prophylactic strategies in BRCA1/2 mutation carriers has confirmed that risk-reducing bilateral salpingo-oophorectomy (RRSO) is associated with a reduction in cancer specific and all cause mortality, as well as a 50% reduction in breast cancer risk in premenopausal women. Uptake rates of prophylactic surgery among BRCA1/2 carriers who are non-Hispanic white (NHW) or well educated populations are high, while women from racial and ethnic minority populations with BRCA1/2 mutations appear half as likely to have risk reducing surgery compared to these groups. To date, very few studies have evaluated rates of prophylactic surgery among Latina BRCA1/2 carriers. This research team will be among the first to conduct an observational study to assess outcomes following BRCA1/2 testing among a diverse sample of Latinas. The proposed work will use a two-phase design to refine a survey and make it culturally appropriate for Latinos (phase I), and to administer it to 100 Latinas who carry BRCA1/2 deleterious mutations recruited from four different regions in the US (phase II). Results will allow them to identify specific barriers and design specific intervention strategies to increase uptake of life-saving prophylactic surgery among this underserved yet high risk population of Latina BRCA1/2 carriers.

Study review

This study investigated how Latinas with BRCA 1 or BRCA2 mutations manage their risk of breast and ovarian cancer, including whether they choose to have prophylactic surgery to remove their breasts and/or ovaries. The researchers wanted to enroll up to 80 volunteers from the Army of Women (AOW) from anywhere in the U.S. The Call to Action for this study was sent to AOW members on November 30, 2016. The researchers closed enrollment on August 29, 2017, after the AOW provided them with 8 women who were interested in enrolling in the study.