Abstract B88: Breast cancer risk factors and Gail risk score distribution in a heavily Hispanic population.
Authors: Goodman Deborah , Park Hannah Lui , Ziogas Argyrios , Tannous Chris , Larsen Kathryn , Anton-Culver Hoda 
Published: August 2014

Background: The Athena Breast Health Network is a collaborative University of California (UC) initiative, focused on providing evidence-based innovations in the screening, diagnosis and treatment of cancer, as well as changing the way patients and providers interact to prevent and manage the disease. An initial goal of the Athena project is to integrate standardized risk assessment into breast cancer screening. Women at highest cancer risk are identified and offered personalized counseling and referrals for prevention services. Previous studies have shown a difference in breast cancer risk factor distribution between Hispanics and non-Hispanic whites. This current study will describe these factors in the UC Irvine Athena cohort, a heavily Hispanic population.

Methods: Between March, 2011 and July, 2012, 1,407 patients completed an electronic questionnaire at the time of their screening mammography and consented to enroll in the UC Irvine Athena Breast Health Network as a research participant. The questionnaire collected data on the woman's medical, reproductive, and family cancer history. Body mass index (BMI) was calculated using self-reported weight and height [BMI=weight (kg)/height (m)2]. NCI-Gail breast cancer scores were calculated using age, age at menarche, age at first full-term pregnancy, family history of breast cancer (mother, sister, daughter), number of biopsies, number of biopsies with atypia, and race/ethnicity. Elevated breast cancer risk was defined as a Gail score &gt; 1.67. Our screening cohort was composed of 63.8% Hispanic (n=903), 19.6% non-Hispanic white (n=277), 10.5% Asian (n=148), 1.4% African American (n=20), and 4.2% who were unable to be classified (n=59). This analysis was limited to women who were Hispanic or non-Hispanic whites.

Results: Mean ± SD ages of the Hispanic and non-Hispanic white groups were 53.9 ± 9.9 years and 60.6 ± 11.3 years (p&lt;0.0001), respectively. The Hispanic group had a significantly higher rate of obesity (BMI &gt; 29.9) compared to non-Hispanic whites (42.0% vs 29.9%; p&lt;0.0001), diabetes (10.7% vs 2.5%; p&lt;0.0001) and hypertension (26.7% vs 20.6%; p&lt;0.04), and a lower rate of family cancer history (p&lt;0.015). Hispanics had a significantly lower level of education, older age at menarche, less breast biopsies and biopsies with atypia. They were also less likely to have a mother, sister or daughter with a BRCA mutation or history of breast or ovarian cancer in a first- or second- degree relative compared to the non-Hispanic white group (p&lt;0.01). In the Hispanic group, 4.5% had an elevated 5-year Gail score &gt; 1.67 compared to 33.7% of non-Hispanic whites (p&lt;0.0001). Overall, those with an elevated Gail score were more likely to have reported Jewish ancestry (p&lt;0.002), have a higher educational level (p&lt;0.0001), a history of breast biopsy and atypia (p&lt;0.0001), or a history of a first- or second- degree relative with breast cancer (p&lt;0.0001) and were less likely to be married (p&lt;0.0001).

Conclusion: In the UC Irvine Athena population, breast cancer risk factors and Gail scores differed significantly between Hispanics and non-Hispanic whites. Recognition of racial disparities is critical for implementing a personalized breast cancer screening and prevention program in the community. For example, our study suggests that in a heavily Hispanic population, screening and prevention programs should target obesity reduction, while greater risk reduction in a non-Hispanic white population may be achieved through genetic counseling.

Citation Format: Deborah Goodman, Hannah Lui Park, Argyrios Ziogas, Chris Tannous, Kathryn Larsen, Hoda Anton-Culver. Breast cancer risk factors and Gail risk score distribution in a heavily Hispanic population. [abstract]. In: Proceedings of the Fifth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2012 Oct 27-30; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2012;21(10 Suppl):Abstract nr B88.