A recent study evaluated racial differences in decision making regarding management of breast cancer risk, with a finding that women of different races at risk of breast cancer may face breast cancer risk management in different ways. Study results were reported in the journal PLoS One.
“Although racial differences in the dynamics of prevention decision making have rarely been studied, there is ample evidence of broader racial disparities related to breast cancer,” the study investigators wrote in their report. Through the use of semi-structured interviews, the study investigators aimed to identify whether women at greater risk of breast cancer have different experiences in risk management based on race and if there are consequences for any possible differences in strategies.
Participants were recruited for this study by multiple approaches. Eligible participants were adults who had no prior cancer diagnoses but who had an above-average breast cancer risk. Race and ethnicity were based on self-identification. The semi-structured interviews emphasized discussion of risk- and prevention-related experiences, and results were analyzed based on categorization of participants by race as Black or White.
This study included 50 participants, including 30 non-Hispanic White women and 20 Black women. Risk was considered severe in 12% of the White women based on diagnosed BRCA mutational status, compared with 0% of the Black women, and it was high in 44% of the White women and 38% of the Black women, and moderate in 4% of the White women and 2% of the Black women. However, the investigators also indicated that Black women may be less informed regarding their own level of risk.
Overall, participants’ exposure to family experiences of cancer affected their own conceptualization of breast cancer risk and prevention. Additionally, although 93% of White participants were aware of prophylactic mastectomy and/or oophorectomy, just 75% of Black participants were aware of any surgical options for risk reduction. Black women also tended to rely more on information from primary care providers about breast cancer risk and prevention, whereas White women received more input from specialists. Also, concern about future cancer risk appeared lower in Black participants, for whom this risk competed with various immediate challenges, including current health problems.
Preventive care appeared impacted by financial constraints, with Black women disproportionately affected. White participants in this study more often appeared to have the highest level of socioeconomic status. Disparities also appeared in terms of whether participants had gone through periods of lacking health insurance; 40% of Black participants reported having periods without insurance, compared with 3% of White participants.
Various challenges in approaching breast cancer risk management affect Black and White women, the investigators concluded, also noting that Black women appear to experience additional challenges. “Understanding that one is specifically at risk for breast cancer and being able to invest resources (time, energy, money) in coping with that risk are critical contexts for successful risk management, and Black women often face barriers to both,” the study investigators wrote in their report.
Disclosures: Some authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Padamsee TJ, Muraveva A, Meadows RJ, et al. Racial differences in prevention decision making among U.S. women at high risk of breast cancer: a qualitative study. PLoS One. 2023;18(3):e0278742. doi:10.1371/journal.pone.0278742