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Genetic testing for breast cancer could benefit minorities but is underused

Ten years after the identification of the first breast cancer susceptibility genes so few high-risk minority women have received genetic counseling or testing that the standard methods of calculating risk have not been validated in these groups and the results of genetic testing can still produce surprises.

In the 19 October 2005 issue of JAMA, a research team from the University of Chicago reports for the first time that the predictive model used by genetic counselors to assess risk based on a family history of breast or ovarian cancer and age of diagnosis -- works just as well for families of African ancestry. They also found, however, that the spectrum of mutations that occur in African Americans is "vastly different."

"Access to genetic counseling and testing are an important part of cancer control," said Olufunmilayo Olopade, M.D., professor of medicine and director of the Cancer Risk Clinic at the University of Chicago Hospitals, "but in this fast-moving area of medicine some ethnic minorities are being left behind. We need to encourage high-risk women from all ethnic groups to get counseling and we need to learn more about what specific test results mean for each racial or ethnic group."

African-American women are at higher risk for early-onset breast cancer. Many of the tools used to estimate risk, however, such as the widely used BRCAPRO statistical model, were developed based on trials involving primarily women of European descent, especially Ashkenazi Jewish women.

So Olopade, Rita Nanda, M.D., and colleagues at the Cancer Risk Clinic at the University of Chicago Hospitals, pulled together ten years of counseling and testing data from the clinic supplemented by data from three other U.S. clinics all of which attract diverse groups of patients.

The researchers studied the woman at greatest risk from 155 families (117 from the University of Chicago Hospitals plus 38 from Mayo Clinic, Rush University Medical
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Contact: John Easton
John.Easton@uchospitals.edu
773-702-6241
University of Chicago Medical Center
18-Oct-2005


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