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Family Discussion Plays Role in Breast Cancer Awareness

Openness has major impact on counseling and genetic testing, study shows

FRIDAY, March 21 (HealthDay News) -- The willingness of relatives to discuss a family's cancer history has a major impact on the awareness of genetic counseling and testing among women at moderate risk for breast cancer, according to a preliminary U.S. study.

Previous research found that black women are less likely than white women to have genetic counseling or testing for genetic mutations that increase breast cancer risk, and that black women are more likely to be diagnosed with a later stage of breast cancer and are thus more likely to die from the disease.

Genetic testing looks for BRCA1 and BRCA2, two genes in which mutations greatly increase the risk of breast cancer.

"It's important to understand the many reasons for these differences, so we can better address them," said Kristi D. Graves, a clinical psychologist at the Lombardi Comprehensive Cancer Center, which is part of Georgetown University Medical Center.

"In this study, we evaluated the impact of socio-cultural variables on knowledge and attitudes about BRCA1/2 counseling and testing. We hope to use this information to better understand why there's a difference in testing uptake among black and white women," she said.

Graves and colleagues conducted telephone interviews with 105 women (75 white, 30 black) with a negative breast biopsy history and with at least one relative who had breast or ovarian cancer. In the interviews, the researchers gathered information about the participants' cancer history, perceived risk, worry, medical mistrust, cancer fatalism, family/physician communication, race-based experiences, and knowledge and attitudes towards BRCA 1 and BRCA2 genetic testing.

"We didn't find a statistical difference in knowledge or attitudes between African-American and Caucasian women," Graves said. "We did observe a difference, however, among women who said their families discuss their cancer history versus those families who didn't discuss cancer. We asked the women if they had talked with their relatives about the family's history of breast cancer. The more family members the women talked with, the greater the level of knowledge about genetic counseling and testing."

"We also found that those who felt more vulnerable because they perceived a greater risk of developing breast cancer had less positive attitudes about genetic testing," she added.

The study was to be presented this week at a meeting of the American Society for Preventive Oncology in Bethesda, Md.

In the next phase of this research, Graves will study whether providing educational materials to women improves their willingness to take part in genetic counseling and testing for breast cancer.

More information

The American Association for Clinical Chemistry has more about BRCA1 and BRCA2 tests.

-- Robert Preidt

SOURCE: Georgetown University Medical Center, news release, March 18, 2008

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