title: Breast Cancer Risk Assessment Among Low-Income Women of Color in Primary Care: A Pilot Study.
abstract: OBJECTIVE
  The US Preventive Services Task Force recommends identifying candidates for breast cancer (BC) chemoprevention and referring them for genetic counseling as part of routine care. Little is known about the feasibility of implementing these recommendations or how low-income women of color might respond to individualized risk assessment (IRA) performed by primary care providers (PCPs).
  
  
  METHODS
  Women recruited from a federally qualified health center were given the option to discuss BC risk status with their PCP. Comprehensive IRA was performed using a software tool designed for the primary care environment combining three assessment instruments and providing risk-adapted recommendations for screening, prevention, and genetic referral. Logistic regression models assessed factors associated with wanting to learn and discuss BC risk with PCP.
  
  
  RESULTS
  Of 237 participants, only 12.7% (n = 30) did not want to discuss IRA results with their PCP. Factors associated with lower odds of wanting to learn results included having private insurance and reporting ever having had a mammogram. Factors associated with higher odds of wanting to learn results included older age (50 to 69 years) and increased BC worry. For all women wishing to learn results, IRA was successfully completed and delivered to the PCP immediately before the encounter for incorporation into the well-visit evaluation.
  
  
  CONCLUSIONS
  Incorporation of US Preventive Services Task Force recommendations as part of routine primary care is feasible. Interest in IRA seems high among underserved women. This approach warrants further investigation as a strategy for addressing disparities in BC mortality.
authors.affiliation: Neiswanger Institute for Bioethics, Loyola University Chicago Stritch School of Medicine, Maywood; College of Medicine, University of Illinois at Chicago; Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL; Medical College of Wisconsin, Milwaukee, WI; and Disney Family Center at Providence St Joseph Medical Center, Burbank, CA emanderson@luc.edu.
authors.forename: Emily E
authors.initials: EE
authors.lastname: Anderson
authors.affiliation: Neiswanger Institute for Bioethics, Loyola University Chicago Stritch School of Medicine, Maywood; College of Medicine, University of Illinois at Chicago; Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL; Medical College of Wisconsin, Milwaukee, WI; and Disney Family Center at Providence St Joseph Medical Center, Burbank, CA.
authors.forename: Silvia
authors.initials: S
authors.lastname: Tejeda
authors.affiliation: Neiswanger Institute for Bioethics, Loyola University Chicago Stritch School of Medicine, Maywood; College of Medicine, University of Illinois at Chicago; Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL; Medical College of Wisconsin, Milwaukee, WI; and Disney Family Center at Providence St Joseph Medical Center, Burbank, CA.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Childers
authors.affiliation: Neiswanger Institute for Bioethics, Loyola University Chicago Stritch School of Medicine, Maywood; College of Medicine, University of Illinois at Chicago; Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL; Medical College of Wisconsin, Milwaukee, WI; and Disney Family Center at Providence St Joseph Medical Center, Burbank, CA.
authors.forename: Melinda R
authors.initials: MR
authors.lastname: Stolley
authors.affiliation: Neiswanger Institute for Bioethics, Loyola University Chicago Stritch School of Medicine, Maywood; College of Medicine, University of Illinois at Chicago; Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL; Medical College of Wisconsin, Milwaukee, WI; and Disney Family Center at Providence St Joseph Medical Center, Burbank, CA.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Warnecke
authors.affiliation: Neiswanger Institute for Bioethics, Loyola University Chicago Stritch School of Medicine, Maywood; College of Medicine, University of Illinois at Chicago; Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL; Medical College of Wisconsin, Milwaukee, WI; and Disney Family Center at Providence St Joseph Medical Center, Burbank, CA.
authors.forename: Kent F
authors.initials: KF
authors.lastname: Hoskins
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000208:ethnology / Q000235:genetics / Q000517:prevention & control*; D005260:Female; D005820:Genetic Testing; D006304:Health Status; D006630:Hispanic or Latino; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D010865:Pilot Projects; D011203:Poverty / Q000208:ethnology*; D011320:Primary Health Care; D012017:Referral and Consultation; D018570:Risk Assessment / Q000706:statistics & numerical data; D012307:Risk Factors; D014481:United States; D055815:Young Adult