Breast Cancer in Hispanic/Latina Women

Why Hispanic/Latina women need to be aware of this disease

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Breast cancer is the most commonly diagnosed cancer and the leading cause of cancer deaths in Hispanic/Latina women living in the U.S. While it is also the most common cancer among all women in the US, Hispanic/Latina women have certain special considerations when it comes to this disease.

The rate of breast cancer in Hispanic/Latina women is lower than in non-Hispanic white women. The incidence is even less in Hispanic/Latina women who were not born in the U.S. The low rate often means that Hispanic/Latina women and their healthcare providers are less likely to worry about the disease. Yet, breast cancer tends to affect Hispanic/Latina at a younger age (premenopausal breast cancer) and is more aggressive than in many other populations—so women in this relatively low-risk population need to be aware of the signs of this disease.

There are limited studies about breast cancer in Hispanic/Latina women in the U.S, but that is beginning to change, and we are getting more information about breast cancer in this population. If you are a Hispanic/Latina woman or if you have loved ones who are Hispanic/Latina women, understanding how breast cancer affects this group can help save your life or the life of your loved one.

Screening and Diagnosis

Screening mammograms are the leading method of identifying early breast cancer. According to a National Cancer Society Survey, only 61 percent of Hispanic/Latina women over age 40 reported having a screening mammogram in the two years prior to the survey, compared to 69 percent of black women and 65 percent of white women.

There are several explanations for this, including a lack of health insurance, limited access to health care, and unfamiliarity with the health care system in the US. Language barriers also play a role.

Breast cancer self-examination, which can detect lumps and breast changes— is free— but Hispanic/Latina women do not frequently seek medical attention for breast lumps.

Hispanic/Latina women are more likely to seek care for breast cancer in an emergency situation, once advanced-stage breast cancer begins to cause pain. At this stage, the disease is usually less treatable and usually has a worse prognosis.

Cultural Barriers to Screening

Experts have suggested that there may be some cultural issues that influence Hispanic/Latino women when it comes to screening and treatment of breast cancer. The lower incidence of the disease outside the US means that women who have friends and relatives who live in Hispanic/Latino countries may be less likely to know a friend or family member who had the disease—which naturally makes these women less concerned that it could happen to them.

Disease Stage and Prognosis

Not only do Hispanic/Latina women have lower utilization of screening mammography, but many also delay following up on abnormal screening tests. The resulting delay in the treatment of breast cancer in Hispanic/Latina women affects the prognosis. With time, tumors become larger and are more likely to spread to other areas of the body—requiring more extensive treatment and making them more difficult to eradicate.

But there are other factors besides delayed attention that affect breast cancer prognosis in Hispanic/Latino women.

Differences in the Disease

Hispanic/Latina women are more likely to develop breast cancer before menopause. And breast cancer can be characterized by more aggressive features in Hispanic/Latino women, whether premenopausal or postmenopausal.

Features of breast cancer in Hispanic/Latino women include:

  • Advanced stage: Cancer stage describes how large the breast cancer is and how far it has spread. Advanced stage cancer is large and may have metastasized (spread to other tissues).
  • Higher grade: Breast cancer grade describes the microscopic features of cancer, including how fast the cells multiply and how different they are from normal breast cells. High-grade breast cancer is more likely to grow and spread rapidly and to recur after treatment than low-grade cancer.
  • Hormone receptor negative (HR-): Breast cancers that have estrogen or progesterone hormone receptors may shrink with medication. Hispanic/Latina women tend to have HR- breast cancer, which does not improve with hormone modifying medication.
  • Human epidermal growth factor receptor 2 positive (HER2+): A protein that can be detected in breast cancer cells, HER2, is associated with a worse breast cancer prognosis. Hispanic/Latina women are more likely to be diagnosed with HER2+ breast cancer.

These differences have a major impact on a woman's treatment options, side effects of treatment, and prognosis. It isn't quite clear why breast cancer in Hispanic/Latino women is more aggressive, and hopefully, further studies will clarify the best treatments for these types of cancers.

Treatment

Another issue for Hispanic/Latina women is that they are less likely to receive appropriate and timely breast cancer treatment when compared to non-Hispanic white women. This issue may have a number of contributing factors.

Delays in treatment or inadequate treatment could be due to language barriers, healthcare access and cost, or to a bias on the part of the healthcare team. It is also possible that some Hispanic/Latina women might not seek care after being diagnosed with breast cancer.

Cultural Barriers to Treatment

Unfamiliarity leads to fear of the disease and fear of the treatment. Some women are concerned about losing their hair, breast, and femininity, which could lead to losing their male partner. Some women consider breast cancer to be a punishment for something they did earlier in life and may consider it their duty to accept the punishment.

When it comes to a population of individuals, the group may have some common characteristics, but each individual woman, her family, and her health care team, can have a unique set of issues that affect the medical and surgical treatment of her breast cancer.

Causes and Risk Factors

Hispanic/Latina women born in outside the US. are not as likely to develop breast cancer or to have a history of breast cancer in their families as those born in the US. This suggests that there could be environmental factors that contribute to the development of breast cancer among Hispanic/Latina women in the US.

Women who use high-dose estrogen oral contraceptives for family planning may have an increase in their risk of breast cancer, and this could have some influence on the rise in breast cancer occurrence among Hispanic/Latina women in the US. One study found that agricultural exposure to chemicals was more common among Hispanic/Latina women who had breast cancer in the US.

And another study identified breast cancer genes that are more common among women of Hispanic/Latino descent. While this doesn't completely explain the increase in breast cancer rates when women of this ethnic background move to the US, different genetic tendencies could provide some information about why the disease is different among women of Hispanic/Latino background.

Solutions

Hispanic/Latina women respond well to community-based breast cancer awareness programs, which leads to better outcomes. This is especially true when programs are led by Hispanic/Latina women, particularly survivors who can speak to the need for early detection and treatment.

Having hospital patient navigators that follow patients from diagnosis through treatment, making sure they keep appointments and helping them navigate a complicated healthcare system, can help women adhere to their treatment regime. Bilingual navigators can improve communication between the surgeon and the oncologist and the woman (as well as her family), which helps reduce a woman's level of anxiety.

A Word From Verywell

If we are going to improve health care and support for Hispanic/Latina women with breast cancer, then breast cancer awareness outreach needs to happen in communities where Hispanic/Latina women gather for meetings or social events, such as schools, houses of worship and community centers. Materials need to be in Spanish and community educators, preferably survivors, need to be an ethnic and cultural match to the women living in those communities.

The message needs to be clear: Know your risks for breast cancer. Get a mammogram regularly. Practicing avoidance and denial won't prevent you from getting breast cancer, but early detection and intervention can save your life.

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