The association of race and ethnicity with risk-reducing mastectomies in patients with non-BRCA mutations

Koumani W Ntowe; Samantha M Thomas; Juliet C Dalton; Ebunoluwa Olunuga; Ton Wang; Akiko Chiba; Jennifer K Plichta

doi:10.1016/j.amjsurg.2025.116485

The association of race and ethnicity with risk-reducing mastectomies in patients with non-BRCA mutations

Am J Surg. 2025 Sep:247:116485. doi: 10.1016/j.amjsurg.2025.116485. Epub 2025 Jun 18.

Authors

Koumani W Ntowe¹, Samantha M Thomas², Juliet C Dalton³, Ebunoluwa Olunuga⁴, Ton Wang⁵, Akiko Chiba⁶, Jennifer K Plichta⁷

Affiliations

¹ Department of Surgery, Duke University Medical Center, 2301 Erwin Rd, Durham, NC, 27707, USA. Electronic address: koumani.ntowe@duke.edu.
² Duke Cancer Institute, Duke University, 10 Bryan Searle Drive, Durham, NC, 27710, USA; Department of Biostatistics and Bioinformatics, Duke University, 40 Duke Medicine Circle, Durham, NC, 27710, USA. Electronic address: samantha.thomas@duke.edu.
³ Department of Surgery, Duke University Medical Center, 2301 Erwin Rd, Durham, NC, 27707, USA. Electronic address: juliet.dalton@duke.edu.
⁴ Department of Surgery, Duke University Medical Center, 2301 Erwin Rd, Durham, NC, 27707, USA. Electronic address: ebun.olunuga@duke.edu.
⁵ Department of Surgery, Duke University Medical Center, 2301 Erwin Rd, Durham, NC, 27707, USA; Duke Cancer Institute, Duke University, 10 Bryan Searle Drive, Durham, NC, 27710, USA. Electronic address: ton.wang@duke.edu.
⁶ Department of Surgery, Duke University Medical Center, 2301 Erwin Rd, Durham, NC, 27707, USA; Duke Cancer Institute, Duke University, 10 Bryan Searle Drive, Durham, NC, 27710, USA. Electronic address: akiko.chiba@duke.edu.
⁷ Department of Surgery, Duke University Medical Center, 2301 Erwin Rd, Durham, NC, 27707, USA; Duke Cancer Institute, Duke University, 10 Bryan Searle Drive, Durham, NC, 27710, USA; Department of Population Health Sciences, Duke University Medical Center, 215 Morris St, Durham, NC, 27701, USA. Electronic address: jennifer.plichta@duke.edu.

PMID: 40544640
PMCID: PMC12350064 (available on 2026-06-18)
DOI: 10.1016/j.amjsurg.2025.116485

Abstract

Introduction: We compared rates of risk reducing mastectomies (RRM) in patients with breast cancer (BC)-related pathogenic variants.

Methods: Female patients ages ≥18 with a BC-related pathogenic variant, without a concurrent or prior BC diagnosis, were identified from a single academic center's database. Patients were stratified by BRCA mutations, high penetrance mutations (HPM), and moderate penetrance mutations (MPM). Race and ethnicity were classified as non-Hispanic White (NHW), non-Hispanic Black (NHB), non-Hispanic other (NHO), and Hispanic.

Results: Our study included 528 patients, which included 79.2 % (n = 418) NHW, 7.0 % (n = 37) NHB, 3.6 % (n = 19) NHO, and 3.4 % (n = 18) Hispanic patients. Overall, 16.5 % of patients underwent RRM: 18.4 % of NHW, 10.8 % of NHB, 5.6 % of Hispanic (p = 0.45). For NHB and Hispanic patients, no individuals with HPMs (NHB 0/6, Hispanic 0/5) or MPMs (NHB 0/11, Hispanic 0/4) underwent RRM.

Conclusions: Our findings suggest that race and ethnicity may be associated with the decision to undergo RRM.

Keywords: BRCA; Breast cancer; Disparities; Genetic testing; Prophylactic mastectomy; Risk reducing mastectomy.

MeSH terms

Adult
Aged
Breast Neoplasms* / ethnology
Breast Neoplasms* / genetics
Breast Neoplasms* / prevention & control
Breast Neoplasms* / surgery
Ethnicity
Female
Hispanic or Latino / statistics & numerical data
Humans
Middle Aged
Mutation
Prophylactic Mastectomy* / statistics & numerical data
Retrospective Studies
White

Abstract

MeSH terms

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