Introduction Genetic testing is an increasingly important part of cancer treatment for women with breast cancer diagnosed under age 45. There has been evidence about low testing uptake and barriers to genetic testing for eligible Black women but less is known about motivations for testing. The objective of this study was to assess reasons for pursuing genetic testing among young Black women with breast cancer. Methods Study participants were a population-based sample of self-identified Black women diagnosed with invasive breast cancer at or below age 50, recruited through the Florida and Tennessee state cancer registries. Participants were categorized into tested and not tested groups. Among the tested, participants were asked why they pursued testing and response options included to guide surgical decisions, chemotherapeutic decisions, radiation decisions, or to benefit family. Respondents were categorized into 4 groups: no motivation specified; treatment motivation only; family benefit motivation only; both treatment and family motivation. Logistic regression was used to estimate factors associated with type of motivation. Results In total, 175 women were eligible for inclusion, 135 women had received genetic testing, and 40 had not. Median age of breast cancer diagnosis was 43. Among tested women, 30 (22%) endorsed treatment motivation only, 69 (51%) endorsed family motivation only, and 31 (23%) endorsed both treatment and family motivation. Women who had daughters had higher odds of endorsing being motivated by family benefit (OR 3.87, 95% CI 1.98, 7.57). This relationship was not seen for having sons (OR 0.84, 0.49, 1.83), sisters (OR 0.78, 95% CI 0.34, 1.77) or brothers (0.87, 0.43, 1.73). Among the 40 women who did not receive genetic testing, 24 (60%) indicated a lack of testing recommendation. Conclusions In our investigation, we found that a greater number of Black women were motivated to pursue genetic testing because of the potential benefit to family members rather than to guide treatment decisions. This finding was especially pronounced among women who had daughters. The null relationship between having sons or either gender sibling and motivation driven by family benefit may reflect greater awareness of BRCA associations with female breast cancer and low awareness of male breast and other BRCA associated cancers. Our findings suggest that conversations around the importance of genetic testing may need to go beyond the importance of guiding treatment decisions and include discussions around the potential benefit for family members.

Citation Format: Mya L. Roberson, Sonya Reid, Tuya Pal. Reasons for pursuing genetic testing among young Black women with breast cancer [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr C007.