BRCA1/2 mutations and risk-reducing bilateral salpingo-oophorectomy among Latinas: The UPTAKE study

Affiliations

PMID: 33010199
DOI: 10.1002/jgc4.1322

Abstract

Bilateral salpingo-oophorectomy (BSO) is a risk management approach with strong evidence of mortality reduction for women with germline mutations in the tumor suppressor genes BRCA1 and BRCA2 (BRCA1/2). Few studies to date have evaluated uptake of BSO in women from diverse racial and ethnic backgrounds who carry BRCA1/2 mutations. The objective of the UPTAKE study was to explore rates and predictors of risk-reducing BSO among Latinas affected and unaffected with breast cancer who had a deleterious BRCA1/2 mutation. We recruited 100 Latina women with deleterious BRCA1/2 mutations from community hospitals, academic health systems, community, and advocacy organizations. Women completed interviews in Spanish or English. We obtained copies of genetic test reports for participants who provided signed medical release. After performing threefold cross-validation LASSO for variable selection, we used multiple logistic regression to identify demographic and clinical predictors of BSO. Among 100 participants, 68 had undergone BSO at the time of interview. Of these 68, 35 were US-born (61% of all US-born participants) and 33 were not (77% of the non-US-born participants). Among Latinas with BRCA1/2 mutations, older age (p = 0.004), personal history of breast cancer (p = 0.003), higher income (p = 0.002), and not having a full-time job (p = 0.027) were identified as variables significantly associated with uptake of BSO. Results suggest a high rate of uptake of risk-reducing BSO among a sample of Latinas with BRCA1/2 mutations living in the US. We document factors associated with BSO uptake in a diverse sample of women. Relevant to genetic counseling, our findings identify possible targets for supporting Latinas' decision-making about BSO following receipt of a positive BRCA1/2 test.

Keywords: BRCA1; BRCA2; attitudes; bilateral salpingo-oophorectomy; disparities; genetic counseling; genetic testing; hereditary breast and ovarian cancer; risk management; underrepresented populations.

References

REFERENCES

1. ACOG (2017). Hereditary breast and ovarian cancer syndrome. Practice Bulletin Obstetrics & Gynecology, 130, e110-126.
1. Antoniou, A., Pharoah, P. D., Narod, S., Risch, H. A., Eyfjord, J. E., Hopper, J. L., … Easton, D. F. (2003). Average risks of breast and ovarian cancer associated with BRCA1 or BRCA2 mutations detected in case Series unselected for family history: A combined analysis of 22 studies. The American Journal of Human Genetics, 72(5), 1117-1130. https://doi.org/10.1086/375033.
1. Baxter, N. N., Goodwin, P. J., McLeod, R. S., Dion, R., Devins, G., & Bombardier, C. (2006). Reliability and validity of the body image after breast cancer questionnaire. The Breast Journal, 12(3), 221-232. https://doi.org/10.1111/j.1075-122X.2006.00246.x.
1. Berrigan, D., Forsyth, B. H., Helba, C., Levin, K., Norberg, A., & Willis, G. B. (2010). Cognitive testing of physical activity and acculturation questions in recent and long-term Latino immigrants. BMC Public Health, 10, 481. https://doi.org/10.1186/1471-2458-10-481.
1. Bradbury, A. R., Ibe, C. N., Dignam, J. J., Cummings, S. A., Verp, M., White, M. A., … Olopade, O. I. (2008). Uptake and timing of bilateral prophylactic salpingo-oophorectomy among BRCA1 and BRCA2 mutation carriers. Genetics in Medicine, 10(3), 161-166. https://doi.org/10.1097/GIM.0b013e318163487d.