Studying Genomics to Reduce Breast Cancer Disparities
Throughout the year, Susan G. Komen Central and South Jersey is committed to educating and empowering women to take charge of their breast health — particularly the most vulnerable.
Breast cancer affects all races, but minority women are disproportionately affected by breast cancer and at a greater risk of experiencing poorer breast cancer outcomes. Komen CSNJ is dedicated to ensuring all women in our service area have access to and utilize quality breast cancer care.
While black women and white women get breast cancer at about the same rate, black women are dying from breast cancer at a higher rate than white women, and breast cancer is the leading cause of cancer-related death among Latina women. Research suggests that these racial and ethnic disparities in breast cancer outcomes will continue to widen — despite advances in mammography use across all racial and ethnic groups (1).
Researching Breast Cancer Disparities
A recent review of scientific studies explored reasons behind these breast cancer disparities. The review concludes that tumor biology, genomics and differences in patterns of care together contribute to racial and ethnic disparities in breast cancer (2). It suggests that effective strategies for closing the disparity gap should include interventions that are culturally “tailored” to meet patients’ needs. In addition to culturally tailored interventions, the review suggests using tailored therapeutic approaches to reduce outcome disparities in breast cancer.
Research studies continue to demonstrate the genetic diversity of breast cancer, suggesting that understanding breast cancer on a molecular level will lead to the development of more effective therapeutic drugs and strategies for the disease. With each individual breast cancer containing numerous genetic alterations, genetic and genomic tests have been developed to help doctors better understand the best screening and treatment options for women (3).
Understanding the Differences Between Genetics & Genomics
Genetics and genomics, although similar in name, offer very different opportunities in medicine. Genetics involves the study of a single gene — its function and composition. Genetic tests are used to identify gene mutations. The results of a genetic test can confirm or rule out a genetic condition or help determine a person’s chance of developing or passing on a genetic disorder. In breast cancer, genetic tests are used to identify genetic alterations that can lead to breast cancer.
Genomics refers to the study of all the genes and gene products in an individual, as well as how those genes interact with one another and their environment. Cancer genomics have become increasingly important in guiding cancer prognosis and treatment. In breast cancer, some genomic tests not only predict whether breast cancer will recur but also how effective chemotherapy might be against the breast cancer tumor.
Exact Sciences (formerly Genomic Health) is one of the companies providing personalized information based on the underlying biology of each patient’s tumor to help patients and their physicians make individualized treatment decisions. The Oncotype DX test helps predict the likelihood of chemotherapy benefit as well as the chance of cancer recurrence in early-stage breast cancer (3). It is intended for use in all newly diagnosed patients with early-stage estrogen receptor-positive (ER+) and human epidermal growth factor receptor II (HER2) negative breast cancer patients (3).
While Oncotype DX is the most common tumor profiling test in the United States, other tests include MammaPrint, EndoPredict, Mammostrat, and Prosigna.
To take charge of their breast health, this October and throughout the year, we encourage all women to:
- Know your personal risk of developing breast cancer.
2. Get screened when you and your doctor decide its best based on your personal risk of breast cancer.
3. Be your own best advocate. Learn about breast cancer — risk factors, prevention strategies, screening services and treatment options — so that you can work with your doctor on developing a prevention and treatment plan.
4. Know the normal look and feel of your breast.
Resources:
1. “More Than Half a Million Breast Cancer Deaths Averted in the US Over Three Decades.” Science Daily, 11 Feb. 2019, https://www.sciencedaily.com/releases/2019/02/190211083209.htm
2. Daly, B. and Olopade, O. (2015). A perfect storm: How tumor biology, genomics, and health care delivery patterns collide to create a racial survival disparity in breast cancer and proposed interventions for change. CA: A Cancer Journal for Clinicians, 65: 221–238.
3. Oncotype DX — TAILORx Education Toolkit: http://oncotypedxbreast.com/TAILORxToolkit
