Genetic Counseling and Testing in African American Patients With Breast Cancer: A Nationwide Survey of US Breast Oncologists

2021 ◽  
Author(s):  
Foluso O. Ademuyiwa ◽  
Patricia Salyer ◽  
Yu Tao ◽  
Jingqin Luo ◽  
Whitney L. Hensing ◽  
...  
Keyword(s):  
Breast Cancer ◽  
African American ◽  
Genetic Counseling ◽  
African American Women ◽  
White Women ◽  
Nationwide Survey ◽  
The United States ◽  
Perceived Barriers ◽  
American Women ◽  
Counseling And Testing

PURPOSE To determine if physicians' self-reported knowledge, attitudes, and practices regarding genetic counseling and testing (GCT) vary by patients' race. METHODS We conducted a nationwide 49-item survey among breast oncology physicians in the United States. We queried respondents about their own demographics, clinical characteristics, knowledge, attitudes, practices, and perceived barriers in providing GCT to patients with breast cancer. RESULTS Our survey included responses from 277 physicians (females, 58.8%; medical oncologists, 75.1%; academic physicians, 61.7%; and Whites, 67.1%). Only 1.8% indicated that they were more likely to refer a White patient than refer an African American patient for GCT, and 66.9% believed that African American women with breast cancer have lower rates of GCT than White women. Regarding perceived barriers to GCT, 63.4% of respondents indicated that African American women face more barriers than White women do and 21% felt that African American women require more information and guidance during the GCT decision-making process than White women. Although 32% of respondents indicated that lack of trust was a barrier to GCT in all patients, 58.1% felt that this was a greater barrier for African American women ( P < .0001). Only 13.9% believed that noncompliance with GCT is a barrier for all patients, whereas 30.6% believed that African American women are more likely than White women to be noncompliant ( P < .0001). CONCLUSION We demonstrated that racial differences exist in oncology physicians' perceived barriers to GCT for patients with breast cancer. This nationwide survey will serve as a basis for understanding physicians' determinants of GCT for African American women and highlights the necessity of education and interventions to address bias among physicians. Awareness of such physician biases can enable further work to address inequities, ultimately leading to improved GCT equity for African American women with breast cancer.

scholarly journals African American Women and Domestic Violence: Addressing their Voice of Silence

2019 ◽  
Author(s):  
Bernice Kennedy ◽  
Chalice Rhodes (Former Jenkins)
Keyword(s):  
United States ◽  
Domestic Violence ◽  
African American ◽  
Black Women ◽  
African American Women ◽  
White Women ◽  
The United States ◽  
Slave Owner ◽  
American Women ◽  
Strong Black Women

Abstract Historically, during slavery, the international slave trade promoted normalization of violence against African American women. During slavery, African American women endured inhuman conditions because of the majority race views of them as being over-sexualized, physically strong, and immoral. This perception of the African American women as being highly sexual and more sexual than white women results in slave owner justifying their sexual violation and degrading of the African American women. The stereotypical representations of African American women as strong, controlling, dangerous, fearless, and invulnerable may interfere with the African American women receiving the needed services for domestic violence in the community. The Strong Black Women Archetype has been dated back to slavery describing their coping mechanism in dealing with oppression by developing a strong, less traditionally female role. The authors developed a model: The Multidimensional Perspectives of Factors Contributing to Domestic Violence of African American Women in the United States. This model depicts historically, the factors contributing to domestic violence of African American women in the United States. Also, this model addressed the African American women subscribing to the Strong Black Women Archetype to cope with domestic violence. Despite the increase in domestic violence in African American women, they focused more on the issue of racism instead of sexism in America. African American women have experienced the two obstacles of racism and sexism in America. However, African American women and men believe racism is more critical than sexism. Therefore, domestic violence in the African American population may remain silent because of cultural loyalty. However, the voice of silence of African American females is gradually changing with the upcoming generations.

scholarly journals Effect of Genetic Counseling and Testing for BRCA1 and BRCA2 Mutations in African American Women: A Randomized Trial

2010 ◽  
Vol 13 (7-8) ◽  
pp. 440-448 ◽  
Author(s):  
C.H. Halbert ◽  
L. Kessler ◽  
A.B. Troxel ◽  
J.E. Stopfer ◽  
S. Domchek
Keyword(s):  
African American ◽  
Genetic Counseling ◽  
Randomized Trial ◽  
African American Women ◽  
American Women ◽  
Counseling And Testing

scholarly journals ZDHHC3 as a Risk and Mortality Marker for Breast Cancer in African American Women

2017 ◽  
Vol 16 ◽  
pp. 117693511774664 ◽  
Author(s):  
Nick Kinney ◽  
Robin T Varghese ◽  
Ramu Anandakrishnan ◽  
Harold R “Skip” Garner
Keyword(s):  
Breast Cancer ◽  
African American ◽  
African American Women ◽  
Messenger Rna ◽  
White Women ◽  
African American Woman ◽  
Breast Cancer Mortality ◽  
American Woman ◽  
Ribosomal Gene ◽  
American Women

African American woman are 43% more likely to die from breast cancer than white women and have increased the risk of tumor recurrence despite lower incidence. We investigate variations in microsatellite genomic regions—a type of repetitive DNA—and possible links to the breast cancer mortality gap. We screen 33 854 microsatellites in germline DNA of African American women with and without breast cancer: 4 are statistically significant. These are located in the 3′ UTR (untranslated region) of gene ZDHHC3, an intron of transcribed pseudogene INTS4L1, an intron of ribosomal gene RNA5-8S5, and an intergenic region of chromosome 16. The marker in ZDHHC3 is interesting for 3 reasons: (a) the ZDHHC3 gene is located in region 3p21 which has already been linked to early invasive breast cancer, (b) the Kaplan-Meier estimator demonstrates that ZDHHC3 alterations are associated with poor breast cancer survival in all racial/ethnic groups combined, and (c) data from cBioPortal suggest that ZDHHC3 messenger RNA expression is significantly lower in African Americans compared with whites. These independent lines of evidence make ZDHHC3 a candidate for further investigation.

scholarly journals A Dream Deferred: African American Women’s Diminished Socioeconomic Returns of Postponing Childbearing from Teenage to Adulthood

2020 ◽  
Vol 1 (2) ◽  
pp. 62-76 ◽  
Author(s):  
Shervin Assari ◽  
Shanika Boyce ◽  
Mohsen Bazargan ◽  
Cleopatra H. Caldwell
Keyword(s):  
African American ◽  
African Americans ◽  
Marital Status ◽  
African American Women ◽  
Social Mobility ◽  
White Women ◽  
The United States ◽  
Continuous Measure ◽  
American Women ◽  
Upward Social Mobility

Background: Brookings Institution has identified postponing childbirth from teenage to adulthood as a major strategy that is needed for upward social mobility of women. However, according to the Minorities’ Diminished Returns (MDRs), the associations between aspirations, investments, behaviors, and socioeconomic position (SEP) may be diminished for marginalized groups such as African Americans. Objective: To extend the existing knowledge on the MDRs, the current study had two aims: First to compare White and African American women for the association between postponing childbearing to adulthood and SEP in a national sample of American women. Second, to test correlates of postponing childbearing to adulthood and SEP at birth with long term outcomes 15 years later when the child was 15 years old. Methods: For this longitudinal study, data came from the Fragile Families and Child Well-being Study (FFCWS), a national longitudinal prospective study in the United States (US) that followed an ethnically diverse sample of women from childbirth for 15 years from 1998 to 2016. For the first aim, this study included 2679 women composed of 723 Whites and 1956 African Americans. For the second aim, among 1842 individuals who had available data 15 years later, we measured various economic, behavioral, and mental health outcomes when the child was 15 years old. For aim 1 we ran linear regression. Postponing childbearing to adulthood was the independent variable. The dependent variable, SEP (poverty) was treated as a continuous measure with higher score indicating more poverty. Confounders included marital status and delivery characteristics. For the aim 2, we ran Pearson correlation test (exploratory analysis) to test if baseline SEP correlates with future outcomes. Results: Postponing childbearing from adolescence to adulthood was associated with higher SEP in adulthood, net of all confounders including marital status and education. We found a significant interaction between postponing childbearing from adolescence to adulthood and race on SEP, suggesting that the economic reward of postponing childbearing may be weaker for African American women than for White women. Conclusions: Although postponing the age at childbirth is a recommended strategy for women who wish to maximize their chance of upward social mobility, this strategy may be associated with smaller economic returns for African American women than White women. The results can also be interpreted as MDRs in investments in terms of a postponing childbearing. In a fair society, the same investment should be similarly rewarded across diverse racial groups. In the reality, however, the US society differently rewards White and African American women who postpone childbearing. Research should explore the roles of social stratification, blocked opportunities, and concentrated poverty in explaining the unequal return of such an investment for African American and White women.

Triple negative breast cancer in African American women: Disparity between women in New Orleans versus Louisiana.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e12501-e12501 ◽  
Author(s):  
Michelle Marie Loch ◽  
John Estrada ◽  
Thomas Reske ◽  
Xiangrong Li ◽  
Vivien Chen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
African American ◽  
African American Women ◽  
New Orleans ◽  
White Women ◽  
Triple Negative ◽  
Her2 Status ◽  
Tumor Characteristics ◽  
Empirical Observation ◽  
American Women

e12501 Background: For years clinicians have made the empirical observation that there is an unusually high number of African American women (AAW) with triple-negative (Tneg) breast cancer (BC) in New Orleans (NO). Knowing the rate of Tneg BC in AAW is higher than white women (WW), we explored the hypothesis that AAW in NO have a higher rate of Tneg BC when compared to AAW in the rest of Louisiana (LA). Methods: We analyzed data from the Louisiana Tumor Registry, one of the NCI funded SEER registries, for the tumor characteristics of invasive female BC diagnosed in 2010, focusing on racial disparities; HER2 status was not available for prior to 2010 diagnosis. We explored the association of HER2 status with age, race, ER, PR, HER2, T, N, M to determine crude and adjusted odds ratios and rate distribution of subtypes using SEER*Stat and SAS programs. Results: Overall age-adjusted incidence rate of Tneg BC in AAW was 30 per 100,000 in NO, which was 24% higher than that in AAW in the rest of LA and two-fold the rate in WW of both NO and LA. The highest rate of Tneg BC was seen in AAW aged 65-69 in NO (184.97 per 100,000) compared with 81.5 per 100,000 in AAW aged 55-59 in LA. AAW with Tneg BC in NO were more likely to have more aggressive BC. Young age, black race, large tumor size, higher grade and TNM stage were significantly associated with the high risk of Tneg BC. After adjusting for age, geographic area, and other tumor characteristics, the higher risk of Tneg BC in AAW remained in NO compared with the rest of LA (OR=1.4; 95% CI: 1.01-1.87). Conclusions: AAW in NO are more likely to have poorly differentiated and Tneg BC compared to AAW in the rest of LA. This disparity remains when comparing our data to previously published literature in other parts of the US. We plan to continue our data analysis and compare NO data to the national average as the HER2 data become available in the SEER Program to better characterize the disparity. This newly identified disparity in the AAW population in NO has clinical implications and translational research potential as it enables us to broaden the understanding and treatment of this aggressive disease.

Genetic Counseling and Testing in African American Women Interview

2011 ◽  
Author(s):  
Kristi D. Graves ◽  
Juleen Christopher ◽  
Toni Michelle Harrison ◽  
Beth N. Peshkin ◽  
Claudine Isaacs ◽  
...  
Keyword(s):  
African American ◽  
Genetic Counseling ◽  
African American Women ◽  
American Women ◽  
Counseling And Testing
Sign in / Sign up

Export Citation Format

Share Document