A new study finds that many women diagnosed with breast cancer are concerned about a genetic predisposition for developing other cancers and the chances of a loved one developing cancer.
35 percent of women with breast cancer expressed a strong desire for genetic testing but nearly half of them, 43 percent, didn't talk with their doctors about it. Around 5 percent of breast cancer patients have an inherited genetic mutation that drives their cancer and many of the women who reported interest in genetic testing were at low risk of having a mutation so doctors would not typically discuss genetic risk with them.
Women who have a genetic mutation do face a higher risk of developing a second breast cancer and may wish to consider more aggressive treatment, preventive measures or additional screening.
The study also found that racial minority patients with a strong desire for testing were less likely than white patients to discuss it with a professional, even though studies show that minority patients are not at lower risk for these mutations.
"With recent judicial opinions, direct-to-consumer marketing, and celebrity reports, the public has become much more aware that genetic testing is available. But genetic risk is complex. Even patients unlikely to have elevated genetic risk may still benefit from a discussion,"
says study author Reshma Jagsi, M.D., D.Phil., associate professor of radiation oncology at the University of Michigan Medical School.
The researchers surveyed 1,536 women who had been treated for breast cancer. Patients were identified through the Surveillance, Epidemiology and End Results databases from Detroit and Los Angeles.
Patients who had a strong desire for testing reported being worried that other members of their family might get breast cancer in the future. Worry was highest among Latinas who spoke only Spanish, where 83 percent reported this concern. In addition, these women were more likely to report worry about their own risks when evaluated in long-term follow-up as survivors. Nearly half of those who had an unmet need for discussion about genetic testing were worried about breast cancer. Only a quarter of those who did not have unmet need reported this worry.
"By addressing genetic risk with patients, we can better inform them of their true risk of cancer returning or of developing a new cancer. This could potentially alleviate worry and reduce confusion about cancer risk," says Jagsi, who is also a member of the U-M Institute for Healthcare Policy and Innovation.
Citation: Journal of Clinical Oncology, "Concerns About Cancer Risk and Experiences With Genetic Testing in a Diverse Population of Patients With Breast Cancer," April 6, 2015. Additional authors: Kent A. Griffith, M.S.; Steven J. Katz, M.D., M.P.H.; Sarah T. Hawley, Ph.D., M.P.H., University of Michigan; Allison W. Kurian, M.D., M.Sc., Stanford University; Monica Morrow, M.D., Memorial Sloan-Kettering Cancer Center; Ann S. Hamilton, Ph.D., University of Southern California; John Graff, Ph.D., Cancer Institute of New Jersey. Funding: National Cancer Institute grants R01 CA109696, R01 CA088370, K05 CA111340; American Cancer Society grant MRSG-09-145-01