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Racial disparities present in access to breast cancer genetic testing

Research finds Black women referred for genetic testing less often

When it comes to catching breast cancer before it takes hold, genetic testing is an important tool to help identify people who are at a high risk for hereditary breast cancer.

But, while white women are slightly more likely to be diagnosed with breast cancer, Black women are 40% more likely to die from the disease -- and that is in part due to racial disparities in diagnosing and treatments, including genetic testing.

Neonatal intensive care nurse Kimyattah Frazier feels empowered in her job, but in her personal life, she could do very little as she watched one relative after another battle breast cancer.

“My mother just passed away from breast cancer,” Frazier said. “Her sister is currently dealing with stage four triple negative breast cancer. She lost her older sister to breast cancer, and my grandmother, who also had breast cancer.”

Three aunts on Frazier’s father’s side of the family also had breast cancer. The illness has impacted her family across several generations.

With genetic testing, technicians take a person’s blood or saliva and look for mutations. This testing helps patients like Frazier to take preventative measures if they do test positive for a known gene mutation associated with breast cancer.

“We may want to screen your breasts more frequently,” said genetic counselor Dana Farengo-Clark. “We may want to do a colonoscopy earlier than you would’ve needed it.”

But research finds that white woman are almost five times more likely than Black women to be referred for genetic counseling and testing. One study found some doctors believed Black patients were more likely to refuse testing, less likely to trust their recommendation and faced more cost barriers to testing.

While so patients do face cost barriers, most insurance agencies now cover genetic testing. And, over the past decade, the cost of testing has dropped to about $250, and sometimes as little as $100.

Related: Know the risk: Here are some surprising facts about breast cancer

Despite her strong family history, none of Frazier’s doctors had recommended genetic testing until she asked about it.

“It’s not painful. It’s nothing bad. It can very well save your life or extend your life,” Frazier said.

“We always wait for the disease to happen, and then we treat it,” Farengo-Clark said. “Genetic testing gives you the opportunity to prevent something.”

Frazier’s test came back negative for mutations in the BRCA1 and BRCA2 genes, as well as a number of other breast cancer genes on the panel.

But, because of that strong family history, Frazier will still receive more frequent screenings, including mammograms or breast MRIs every six months.

The bottom line: If you have a strong family history of cancer, ask your doctor if genetic counseling and testing would be helpful and, if not, why not. It’s also important to take the initiative and find out what your insurance covers.

These tests can make a major difference in your screening and detecting any cancer much earlier, or even taking measures to prevent it.


Related: Breast cancer survivors tell all: ‘If you feel something and it doesn’t show on the mammogram, keep pointing it out’


About the Author
Frank McGeorge, MD headshot

Dr. McGeorge can be seen on Local 4 News helping Metro Detroiters with health concerns when he isn't helping save lives in the emergency room at Henry Ford Hospital.

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