Dr Sheen on Racial Disparities in Physiology, Genetic Testing in Breast Cancer

“We found that there's a big health care disparity gap in patients [who are] going to see our genetic counselors, [and] we're seeing [that] those who are getting tested [have] a higher rate of genetic alterations.”

Melanie A. Sheen, MD, a hematologist and oncologist at Ochsner MD Anderson Cancer Center, discusses findings from a study evaluating disparities in breast density and genetic testing among White and African American women with breast cancer.

The study, presented at the 2024 San Antonio Breast Cancer Symposium aimed to determine differences in breast composition and assess racial disparities in access to and utilization of genetic counseling and testing.

Findings indicated that White and African American women had comparable rates of extremely dense breast tissue. However, White women were more likely to have heterogeneously dense or fatty breast tissue. The study also found that women with a higher total cancer (TC) score—specifically those exceeding 40%—had an increased likelihood of abnormal MRI findings, regardless of race.

A significant disparity emerged in the utilization of genetic counseling and testing services. White women were more likely to attend genetic referral appointments, whereas African American women had lower attendance rates, Sheen explains. Notably, among African American women who underwent genetic testing, over half were found to have genetic mutations, highlighting a critical gap in access to genetic counseling for this population, she emphasizes.

These findings underscore a substantial disparity in genetic risk assessment and potential preventive strategies. The underutilization of genetic services by African American women, despite their higher prevalence of genetic alterations, suggests that barriers such as health care access, socioeconomic factors, provider referral patterns, or patient awareness may contribute to this discrepancy.

Sheen emphasizes the need for targeted interventions to improve referral adherence and genetic testing rates among African American patients with breast cancer. Addressing systemic barriers to care and implementing tailored outreach programs may enhance genetic risk assessment and early intervention for this population.