Genetic testing and surgical treatment after breast cancer diagnosis: Results from a national online cohort

Verdial, Francys C.; Bartek, Matthew A.; Anderson, Benjamin O.; Javid, Sara H.

doi:10.1002/jso.26372

Cited by 3 publications

(1 citation statement)

References 38 publications

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“…In particular, despite there being no evidence to suggest that Black women with breast cancer have lower rates of BRCA1/2 pathogenic variants than White women, 3 studies from several states have found that Black women with breast cancer have lower rates of indicated testing than White women. [4][5][6] These inequities are particularly concerning given that Black women are more likely to be diagnosed with breast cancer before age 40 than White women and have higher breast cancer mortality rates. 7,8 The contribution of insurance coverage and access to racial/ethnic disparities in BRCA testing is not well understood.…”

Section: Introductionmentioning

confidence: 99%

BRCA1/2 testing among young women with breast cancer in Massachusetts, 2010–2013: An observational study using state cancer registry and All‐Payer claims data

et al. 2022

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Background Testing for BRCA1/2 pathogenic variants is recommended for women aged ≤45 years with breast cancer. Some studies have found racial/ethnic and socioeconomic disparities in testing. We linked Massachusetts' All‐Payer Claims Database with Massachusetts Cancer Registry data to assess factors associated with BRCA1/2 testing among young women with breast cancer in Massachusetts, a state with high levels of access to care and equitable insurance coverage of breast cancer gene ( BRCA) testing. Methods We identified breast cancer diagnoses in the Massachusetts Cancer Registry from 2010 to 2013 and linked registry data with Massachusetts All‐Payer Claims Data from 2010 to 2014 among women aged ≤45 years with private insurance or Medicaid. We used multivariable logistic regression to examine factors associated with BRCA1/2 testing within 6 months of diagnosis. Results The study population included 2424 women; 80.3% were identified as non‐Hispanic White, 6.4% non‐Hispanic Black, and 6.3% Hispanic. Overall, 54.9% received BRCA1/2 testing within 6 months of breast cancer diagnosis. In adjusted analyses, non‐Hispanic Black women had less than half the odds of testing compared with non‐Hispanic White women (adjusted odds ratio [OR] = 0.45, 95% CI = 0.31, 0.64). Medicaid‐insured women had half the odds of testing compared with privately‐insured women (OR = 0.51, 95% CI = 0.41, 0.63). Living in lower‐income areas was also associated with lower odds of testing. Having an academically‐affiliated oncology clinician was not associated with testing. Conclusion Socioeconomic and racial/ethnic disparities exist in BRCA1/2 testing among women with breast cancer in Massachusetts, despite equitable insurance coverage of testing. Further research should examine whether disparities have persisted with growing testing awareness and availability over time.

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