Abstract MS3-2: Advances in Breast Cancer Risk Assessment, Screening and Prevention: Adapting the Lessons to an Underserved Latina Population

Abstract

Abstract Breast cancer (BC) is the most common cancer and the leading cause of cancer death in Latina women. Mutations in BRCA genes are associated with 5% of all BC and a larger proportion of young women with BC. Genetic cancer risk assessment (GCRA) has the potential to identify persons at increased risk for cancer prior to the onset of disease, when early detection or prevention strategies would be most effective. Despite clinical studies documenting the efficacy of cancer risk reduction measures in high-risk individuals, low-income, underinsured or ethnic minority individuals have a disproportionate burden of cancer and limited access to GCRA. City of Hope Cancer Screening & Prevention Program Network outreach clinics were established in two regional indigent healthcare delivery systems. Consultations are facilitated by an experienced bilingual cancer risk counselor/physician team and risk management recommendations are given based on BRCA test results or empiric risk estimates. We observed a high prevalence of deleterious BRCA mutations (25–34%) among Latinas seen in a large network of high-risk clinics from Texas to Northern California, and also identified a unique recurrent large BRCA1 rearrangement of presumed Mestizo origin. We also established that the BRCA1 185delAG detected in several independent Latina families shared a common ancestral origin with Jewish carrier families. The presence of additional recurrent mutations led us to pursue ancestry informed strategies for more cost-effective BRCA analyses in underserved Latina populations. Our clinical studies indicate that underserved patients embrace the opportunity for GCRA services, attend their scheduled consultations, have a high level of participation in follow-up surveys and show a positive impact on cancer screening and prevention behaviors. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr MS3-2.