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Breast Cancer Risk Reduction Options: Awareness, Discussion, and Use among Women from Four Ethnic Groups

¹ Division of General Internal Medicine; Department of Medicine, Medical Effectiveness Research Center for Diverse Populations, ² University of California, San Francisco Comprehensive Cancer Center; ³ General Internal Medicine Section, Department of Veterans' Affairs, Department of Epidemiology and Biostatistics; Department of Medicine, University of California, San Francisco; ⁴ Division of Research, Kaiser Permanente Northern California, Oakland, California; and ⁵ Division of General Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts

Requests for reprints: Celia Patricia Kaplan, Division of General Internal Medicine, Department of Medicine, University of California San Francisco, 3333 California Street, Room 335-G, San Francisco, CA 94143-0856. Phone: 415-502-5601; Fax: 415-502-8291. E-mail: Celia.Kaplan{at}ucsf.edu

Background: With recent advances in breast cancer risk reduction practices, it is increasingly important to assess both the breadth of and disparities in use across different racial/ethnic groups.

Methods: We conducted telephone interviews with 1,700 women ages 40 to 74, from four racial/ethnic groups, without prior history of breast cancer, who received mammograms at one of five mammography facilities in San Francisco. Main outcomes measured included recognition of tamoxifen, raloxifene, genetic testing, and prophylactic surgery. Global indicators (recognition of any therapy, discussion of breast cancer risk) were developed from original outcome measures and analyzed using logistic regression.

Results: Multivariate analyses indicate that race/ethnicity and interview language affected recognition of therapies and discussion of risk. White women were more likely than all other women to recognize any therapy and more likely than Asian-Americans to discuss risk. Women at high risk, who had a prior abnormal mammogram, who perceived themselves to be at high risk, or who were exposed to breast health information were more likely to discuss risk.

Conclusions: Women are aware of preventive therapies, although discussion and use is limited. Interventions to increase use of therapies should focus on those at high risk. (Cancer Epidemiol Biomarkers Prev 2006;15(1):162–6)

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