Thanks to the Human Genome Project and the identification of the BRCA1 and BRCA2 gene mutations, which increase the risk of breast cancer, many women can now take advantage of genetic testing to find out in advance if they are at risk for developing the disease. Having this knowledge can increase their chances for breast cancer prevention or early detection. But despite these advances, say researchers from Stanford University, many Asian American women with BRCA mutations seem to be falling through the cracks.

According to the research, published in the October 10, 2008 issue of the Journal of Clinical Oncology, two of the most widely used prediction models for identifying women who may be BRCA mutation carriers often fall short in identifying Asian women who are likely to have BRCA1 and BRCA2 mutations. As a result, says the study’s lead author, Dr. Allison W. Kurian, “Asian American women with BRCA mutations may not be referred for genetic testing as often as they should be.” The findings also suggest that BRCA mutations may occur more frequently in Asian women than previously thought.

The researchers tested the effectiveness of two prediction models, BRCAPRO and Myriad II, using a sample of 200 Asian women and 200 white women. Both models, which are based on a woman’s personal and family history of breast cancer and ovarian cancer, are widely used in the U.S. to identify at-risk women who would benefit from genetic testing. But while the models accurately predicted the number of white subjects who turned out to be BRCA mutation carriers, they were far less accurate when it came to the Asian subjects. Of the 49 Asian women who were found to have the mutations, only 25 were predicted by BRCAPRO and 26 by Myriad II.

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