Jeffrey Weitzel, MD

Expanding access to genetic screening and breast cancer prevention in Latin America.

Impact

Breast cancer risk reduction includes genetic cancer risk assessment. However, accessing genetic counseling, detecting high-risk individuals, and offering treatment requires an infrastructure that supports public access to both genetic testing and risk reduction surgery. Access to these services is limited in Latin America. The goal of Dr. Weitzel’s Genomic Risk Assessment for Cancer Implementation and Sustainment (GRACIAS) project is to address disparities and characterize the genetic risk for breast cancer in Latin America through dissemination and implementation of genetic cancer risk assessment, ultimately enabling critical and timely breast cancer interception and prevention interventions for patients and their families.

Progress Thus Far

Dr. Weitzel is implementing genetic cancer risk assessment at pilot sites in Latin America as well as new sites in the region. He and his team have made insights into how Hispanic women in the United States and Latin America are choosing preventive surgeries to reduce their risk of breast and ovarian cancer after receiving genetic counseling and testing. They found that women who carried a breast cancer susceptibility gene mutation, had a personal or family history of cancer, or were younger were more likely to choose risk-reducing surgeries (RSS), such as mastectomy or removal of the ovaries and fallopian tubes. However, women living outside the U.S. were less likely to undergo RSS. Understanding personal and systemic factors influencing uptake may enable interventions to increase risk appropriate uptake of RRS. The team has found that having genetic testing and counseling available help women make informed, risk-appropriate decisions about prevention.

What’s next

Dr. Weitzel and his team will expand recruitment of clinicians to at least one new center in Mexico and are implementing intervention tools such as video counseling and testing a patient-facing mobile app to collect family history and risk factors. The team is also investigating breast cancer predisposition genes aside from BRCA that may help understand heredity breast cancer in Latin America and contribute to risk stratification and prevention.