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Biospecimen donation among black and white breast cancer survivors: opportunities to promote precision medicine



Advances in precision medicine (PM) have potential to reduce and/or eliminate breast cancer disparities in both treatment and survivorship. However, compared to white Americans, black Americans are often underrepresented in genetic research. This report assessed factors that influence receipt of buccal cells via saliva kits.


This prospective study recruited women with confirmed hormonal-positive (HR+) breast cancer (BC). A standardized telephone survey collected sociodemographic, socio-cultural (e.g., religiosity), and healthcare process factors. Clinical information was abstracted from medical records. After the baseline survey, return postage-paid envelopes and mouthwash collection kits were mailed. Univariate and adjusted logistic regression models estimated the probability of biospecimen donation.


Seventy percent of the sample provided buccal cells which were of good quality. No differences were noted by race or other demographic factors. In the multivariable logistic model, time spent with providers (OR 1.61 per 1-point increase; 95% CI 1.242, 2.088) and religiosity (OR 0.957 per 1-point increase; 95% CI 0.931, 0.984) remained associated with biospecimen provision. Women with lower-stage cancer (vs. higher stage III+) were more likely to donate biospecimens (p < 0.05).


Cancer care experiences predicted specimen donation. Understanding the contextual reasons for lower receipt among women with higher religiosity scores and higher stage warrants further examination.

Implications for cancer survivors

PM is relevant to cancer survivors because of its potential to inform targeted therapies, understand disease resistance, and aide in prediction of toxicity and/or recurrence. Future efforts to launch precision medicine trials with BC survivors may benefit from engaging medical oncologists and/or leveraging patient-provider encounters for trial participation.

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The authors are grateful to study participants who took the time to participate in this study. Additionally, we appreciate the diligence of study research assistants Ms. Minna Song and Ms. Themis Elian who helped recruit, consent, and interview women. We also appreciate technical assistance from Dr. Arnethea Sutton and Ms. Megan Edmonds, MPH. Funded by Georgetown-Howard Universities Center for Clinical and Translational Science (GHUCCTS) by Federal Funds, National Center for Advancing Translational Sciences (NCATS), National Institutes of Health (NIH), through the Clinical and Translational Science Awards Program (CTSA) (Hurtado de Mendoza: KL2TR001432).


This research was funded by the National Institutes of Health R01CA154848 (Sheppard) and R01 CA132996 (Zheng). It was also supported in part by the NIH-NCI Cancer Center Support Grant P30 CA016059, Nontherapeutic Subject Registry Shared Resource at Lombardi Comprehensive Cancer Center under NCI Grant: NTSR P30 CA51008, and the Laboratory of Telomere Health P30 CA51008.

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Correspondence to Vanessa B. Sheppard.

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The authors declare that they have no conflicts of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Sheppard, V.B., Hurtado-de-Mendoza, A., Zheng, YL. et al. Biospecimen donation among black and white breast cancer survivors: opportunities to promote precision medicine. J Cancer Surviv 12, 74–81 (2018).

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  • Precision medicine
  • Biospecimen
  • Survivors
  • Disparities