Awareness of Heightened Breast Cancer Risk Among First-Degree Relatives of Recently Diagnosed Breast Cancer Patients

This investigation had two goals: (a) to determine the proportion of first-degree relatives of recently diagnosed breast cancer patients who are unaware of their elevated risk for breast cancer; and (£) to identify demographic, medical, and lifestyle factors that characterize these women. The ultimate objective was to identify women at increased risk who could benefit from breast cancer risk education. Three hundred ninety-five female first-degree relatives, ages 30-75 years, completed a structured telephone interview. Twenty-five % of these women believed that their risk for breast cancer was the “same as or lower than” women who do not have a family history of breast cancer, despite the fact that they had an objectively increased risk. Bivariate analyses revealed that women who were unmarried (X² = 14.8; P = 0.001) and had less than or equal to a high school education (X² = 9.2; P = 0.002) were significantly less likely to perceive themselves as being at increased risk for breast cancer. In addition, almost one-half of African-American women were unaware of their increased risk compared to only 19% of white women (X² = 29.9; P < 0.001). More smokers were unaware of their elevated risk compared to nonsmokers (43 versus 21%; X² = 15.1; P < 0.001). In logistic regression analysis, the following three variables were significant independent “predictors” of lack of awareness of heightened breast cancer risk: (a) being African American versus white (odds ratio = 5.5; confidence interval = 2.5-12.0); (b) currently smoking (odds ratio = 4.0; confidence interval = 1.9-8.3); and (c) the absence of formal risk notification by a health care provider (odds ratio = 2.2; confidence interval = 1.1-4.2). On the basis of these results, it appears important to target smokers and ethnic minorities for breast cancer risk education programs.