Abstract P2-07-10: Breast health behaviors of women under 40 accessing the Avon breast health outreach program

Abstract

Background Breast cancer is the most common cancer among women, and tends to be more aggressive when diagnosed in women <40 years. However, limited research exists on breast health behaviors of women <40. This study analyzes trends in breast health behaviors and diagnostic data among women <40 served by the Avon Breast Health Outreach Program (BHOP) which links medically underserved women to breast health education and screening services. Methods Confidential client intake records of female clients (n= 192,296) of Avon BHOP grantees continuously-funded from 2011-2015 were analyzed, along with breast cancer diagnosis data from a select number of clients (n=82) from January-March 2016. Results Approximately 7% of Avon BHOP clients from 2011-2015 were <40 years (n=12,872). Women <40 had a significantly lower odds of having been taught breast self-exam (BSE), knowing about mammograms before their visit, having had a clinical breast exam (CBE) in the past 2 years, and having had a mammogram in the past 2 years compared to women ≥40. Over 80% of women <40 reported being taught BSE and knowing about mammograms before their visit, compared to 94% among women ≥40. The percent who reported a CBE in the past 2 years increased by approximately 5% among both <40 and ≥40 women, to a high of 64.6% and 78.2%, respectively, in 2015. Reporting a mammogram in the past 2 years also increased by approximately 5% in both groups, to a high of 25.9% and 70.3%, respectively, in 2015. Women <40 had a significantly higher odds of having breast-related symptoms (OR=7.64) and a relative diagnosed with breast cancer (OR=1.23) compared to women ≥40. For women <40, the adjusted odds of having had a mammogram in the past 2 years were 1.34 times higher (p<0.001) among those who had a relative diagnosed with breast cancer compared to those who did not, while the odds were 1.09 (p<0.001) among women ≥40. From January-March 2016, 10 breast cancer cases in women <40 were reported by 7 Avon BHOP grantees; 38 cases were reported in women ≥40. Of the 10 diagnosed cases, the majority were Hispanic (70%) and 30% were Stage IV compared to 6% among women ≥40, however the difference was not statistically significant (p=0.096). Discussion In 2015 the American Cancer Society estimated that 4.2% of breast cancer cases were diagnosed in women <40. While the Avon BHOP diagnosis data is limited, the results nonetheless demonstrate a higher rate of breast cancer in this age group. Additionally, the association between being <40 and having a later stage diagnosis compared to those ≥40 appears to be a meaningful trend, and, while not significant in our preliminary data, we anticipate the finding to persist. While Avon BHOP clients <40 had a significantly lower odds of knowing about screening behaviors compared to ≥40, a large percentage had knowledge of breast health, and increasingly reported higher rates of screening behaviors. There was also a greater positive association between having a relative with breast cancer and having had a mammogram in the past 2 years in women <40 compared to ≥40. These findings suggest that Avon BHOP clients <40 increasingly understand their breast cancer risk and seek screening services accordingly. It is important to provide clear screening guidelines for this population. Citation Format: Gates-Ferris K, Bauer KM, Senter L. Breast health behaviors of women under 40 accessing the Avon breast health outreach program [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P2-07-10.