by Pat Kramer
More Latinas die of breast cancer than any other cancer, and new evidence suggests that mutations in the so-called breast cancer genes are prevalent in women of Mexican descent and may be partly to blame.
In three separate studies, City of Hope researchers are providing genetic cancer risk assessment services to Latinas, trying to determine more effective ways to help this underserved population. The studies are led by Jeffrey Weitzel, M.D., director of the Department of Clinical Cancer Genetics, in collaboration with Martin Perez, Ph.D., co-director of the Department of Psychology.
In the first study, Latina patients seen at City of Hope’s Cancer Screening & Prevention Program, including those at two free clinics in Los Angeles, receive genetic cancer risk assessment to identify those with mutations in BRCA1 or BRCA2 genes. The testing identifies 12 different mutations in BRCA genes previously identified in families of Mexican descent. Researchers also are collaborating with additional high-risk clinics that care for underserved Latinas in Arizona, New Mexico and Texas.
Women carrying BRCA gene mutations face a much higher risk of developing breast or ovarian cancer, often before age 40. While BRCA mutations account for only 5 to 10 percent of all breast cancer cases, carriers have up to an 85 percent lifetime risk of breast cancer. Eventually, researchers hope to develop a cost-effective screening panel that will easily identify mutations in Latinas. The research, called the Hereditary Breast Cancer and Novel Hispanic BRCA Mutations study, is supported by a $150,000 grant from the California Breast Cancer Research Program.
Weitzel’s team also is collaborating with University of Southern California researchers to understand a mutation in Latinas that appears ancestrally related to ancient Jews, as well as another mutation discovered in Weitzel’s lab that may originate in Mexico.
The second study, Cancer Risk Counseling for Underserved Women, examines the cognitive, social and cultural factors that influence underserved Latinas’ perception of their access to preventive measures such as breast cancer screenings, mammography and prophylactic surgery. The Susan G. Komen Breast Cancer Foundation funds the two-year study through a $250,000 grant.
“Low-income, underinsured or ethnic minority individuals have higher rates of cancer and little access to genetic cancer risk assessments,” said Weitzel. “These assessments may identify those at high risk for cancer, before the onset of the disease, when screening and cancer prevention efforts are most effective.”
Researchers hope the assessments will lead to regular breast screenings for candidates.
“Once we find a mutation, we can then go on to test other at-risk family members for the same mutation,” said Veronica Lagos, project coordinator for the study. “We have the ability to impact an entire family from the first individual we see, targeting those at higher risk for breast cancer.”
Perez, meanwhile, is a key partner in the behavioral research aspects of the program. His study, called Culturally Relevant Cancer Risk Counseling for Underserved Latinas, is funded by a $75,000 pilot grant from Redes En Acción, a National Cancer Institute-supported initiative to combat cancer among Latinos.
In early 2007, the researchers will hold focus groups with Latinas of Mexican descent who have recently undergone genetic cancer risk assessment, seeking to learn how to adapt these services more effectively to such women.
Researchers hope the studies, which range from molecular genetics to behavioral outcomes, will fill gaps in knowledge about hereditary breast cancer in Latinas and guide effective practices to benefit the rapidly growing population.