title: Comparing breast cancer risk between lesbians and their heterosexual sisters.
abstract: OBJECTIVE
  The purpose of this study was to explore the similarities and differences between lesbians and their heterosexual sisters in the established risks for developing breast cancer.
  
  
  METHODS
  The design for this study was a matched (lesbian with heterosexual sister) cross-sectional, mail-back, anonymous survey. We distributed the surveys throughout the state of California to English-speaking women who identified themselves as lesbians, age 40 and older, and their sisters. Using the modified Gail Breast Cancer Risk model as well as other well-established factors associated with the development of breast cancer, we compared the breast cancer risk potential for 324 sister pairs (N = 648). Data were analyzed using paired t-tests, analysis of covariance (ANCOVA), McNemar's chi(2), or the Bowker statistic, as appropriate for the level of data.
  
  
  RESULTS
  The lesbians had significantly higher 5-year (p <.0001) and lifetime (p =.001) risk for developing breast cancer. The reasons for lesbians' predicted rate of breast cancer were most likely their higher scores on all pregnancy-related variables and the relatively high number of breast biopsies they reported. The lesbians had used birth control pills less (p <. 0001), had significantly fewer pregnancies (p <.0001), children (p <.0001), abortions (p <.0001), and miscarriages (p <.0001) as well as significantly more breast biopsies (p =.02) than did their heterosexual sisters.
  
  
  CONCLUSIONS
  A lesbian who comes out to her clinician is relying on the clinician to be informed and be open to discuss her life. When a lesbian has a lump or a suspicious mammogram, she needs her clinician to advocate for her within the health care system because she is at higher risk for having cancer than a heterosexual woman.
authors.affiliation: Institute for Health & Aging, School of Nursing, University of California, San Francisco, San Francisco, California, USA. sdibble@itsa.ucsf.edu
authors.forename: Suzanne L
authors.initials: SL
authors.lastname: Dibble
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Roberts
authors.forename: Brenda
authors.initials: B
authors.lastname: Nussey
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000209:etiology / Q000517:prevention & control; D002140:California; D016009:Chi-Square Distribution; D005260:Female; D020010:Heterosexuality / Q000706:statistics & numerical data*; D018452:Homosexuality, Female / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D010817:Physician-Patient Relations; D011788:Quality of Life / Q000523:psychology; D018570:Risk Assessment; D012307:Risk Factors; D012650:Self Disclosure; D035781:Siblings; D011795:Surveys and Questionnaires; D013997:Time Factors; D016387:Women's Health