Despite attention to psychological issues during genetic counselling and testing for hereditary breast and ovarian cancer risk, limited information is available on cancer-specific distress among African American women being targeted for participation in counselling and testing. Therefore, the purpose of this study is to examine cancer-specific distress in African American women at an increased risk of hereditary breast and ovarian cancer and to identify factors having significant associations with distress in this population. Respondents were 141 African American women identified for participation in genetic counselling and testing for BRCA1/2 mutations. Overall, respondents reported moderate levels of cancer-specific distress. Younger age (coefficient=6.0, p=0.001), being unemployed (coefficient=-5.0, p=0.01), and having a personal history of cancer (coefficient=5.0, p=0.02) had significant associations with intrusion. Younger age was also associated significantly with greater avoidance (r=6.0, p=0.02). These results suggest that African American women aged 50 and younger, those who are unemployed and women with a personal history of breast or ovarian cancer may be the most vulnerable to experiencing elevated levels of distress during genetic counselling and testing. Greater attention to psychological issues, including concerns about cancer and cancer risks, may be needed during genetic counselling and testing for BRCA1/2 mutations with these women.

#1099 Background: Efforts are now focused on increasing access to genetic counseling and testing for BRCA1 and BRCA2 (BRCA1/2) mutations to address cancer disparities in African American women; however, limited empirical data are available on the effects of these services. Therefore, we evaluated the effects of genetic counseling among African American women at increased risk for hereditary disease.
 Materials and Methods: This study was conducted between February 2003 and November 2006. Participants were African American women (n=139) at increased risk for having a BRCA1 or BRCA2 (BRCA1/2) mutation. The effects of genetic counseling, including culturally tailored (CTGC) versus standard (SGC) counseling, on changes in risk perception and psychological functioning were evaluated.
 Results: Women who participated in genetic counseling had a significantly greater likelihood of reporting reductions in perceived risk compared to non-participants (P=0.03). Women who received BRCA1/2 results also had a significantly greater likelihood of reporting decreases in cancer worry (P=0.03). Similar effects were found among women who had a high prior probability of having a BRCA1/2 mutation (P=0.03) and those affected with cancer (P=0.04). There were no differences in CTGC and SGC in study outcomes.
 Discussion: African American women may experience some benefit from receiving BRCA1/2 test results. Participation in counseling and receiving test results may be especially beneficial to African American women who have high prior probability of having a BRCA1/2 mutation and those affected with cancer. Continued efforts should be made to increase access to genetic counseling and testing among African American women at increased risk for hereditary disease. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1099.

10549 Background: African-American (AA) women more frequently have “triple negative” (ER-, PR-, HER2-) breast cancer (BC) and such BC are more frequently associated with B1 mutations; however, the correlation of triple negative BC in the AA population and B1/2 mutations is not known. We were interested in examining the prevalence of B1/2 mutations in a cohort of AA with early-onset breast as well as the associated pathologic characteristics. Methods: 85 unselected AA women diagnosed with 88 BC at or prior to age 40 were enrolled on study and underwent BRCA1/2 genetic testing by full sequencing at Myriad Genetics following informed consent. MLPA screening for large genomic rearrangements also was performed. Pathology reports were obtained and examined. Results: Of the 85 women, 16 (19%) had either a B1 (11) or B2 (5) deleterious mutation, which were associated with 19 BC. 19/85 (22%) women had a variant of unknown significance (VUS); 3 had B1 VUS, 15 had B2 VUS (including 2 with B1 mutations) and 1 had both B1 and B2 VUS. No mutations were detected with MLPA. Of the 14 BC in 11 B1 mutation carriers, 12 were ER- (86%), 13 were PR- (93%) and 3/12 were HER2+ (25%). Of the 5 BC in B2 carriers, 4 were ER- (80%), 1/4 HER2+ (25%). Receptor status was available in 77 of 88 cases (88%). Overall 41 of 77 (53%) cancers were ER-. 15 of 40 women (38%) with any ER- BC had either a B1 (11) or B2 (4) mutation. In contrast, of the 36 ER+ BC, 2 had a B1 and one had a B2 mutation (8%) (p=0.01). Both B1 carriers with ER+ BC also had a contralateral ER- BC. 18 of 65 (27%) cancers were known to be HER2+, of which 4 of 18 (22%) were associated with B1 or B2 mutations (p=NS). Median age of first BC in B1/B2 mutation carriers was 32 vs. 37 in non-carriers. Conclusions: In unselected AA women with early onset BC, B1/2 mutations were common and predominantly found in association with ER- BC. B2 VUS were detected frequently. HER2 overexpression did not predict against B1/2 mutations. No significant financial relationships to disclose.

6596 Background: Many breast cancer patients use complementary and alternative medicine (CAM), which warrant rigorous evaluation of the safety and efficacy of these therapies. As with conventional cancer treatment studies, researchers face challenges in accruing patients to CAM trials. This study aims to identify the factors associated with willingness to participate (WTP) in a trial evaluating use of acupuncture for arthralgia among breast cancer patients. Methods: We conducted a cross-sectional survey study among outpatient postmenopausal breast cancer patients who were receiving aromatase inhibitors. Self-reported WTP in an acupuncture trial was used as the main outcome variable. Expectation towards acupuncture efficacy was measured using a previously validated Acupuncture Expectancy Scale. Multivariate logistic regression was used to identify factors associated with WTP. Results: 300 patients participated (92% response rate), with a mean age of 61 ± 10 years, 252 (84%) White, and 38 (13%) Black. Of the participants, 148 (49.8%) reported WTP in an acupuncture trial should they be offered an opportunity for such research. In a multivariate model, higher likelihood of WTP was associated with having a college education, adjusted odds ratio (95% confidence interval), 3.78 (1.83–7.81); having previous radiation therapy 2.02 (1.13–3.62); and current experience of arthralgia 2.36 (1.11–4.98). Positive expectancy of acupuncture outcome was also associated with greater likelihood of WTP 1.20 (1.12–1.28). Age and race were not predictors of WTP in the multivariate model. Conclusions: Almost half of the outpatient breast cancer patients expressed WTP in an acupuncture clinical trial for arthralgia. Higher education, previous radiation therapy, current experience of arthralgia, and positive expectancy related to acupuncture may affect breast cancer patients’ willingness to participate in an acupuncture trial for arthralgia. No significant financial relationships to disclose.