Breast cancer is the leading cause of death in Latinas.
In fact, while breast cancer death rates have declined recently, the rate of decline for Latinas is lower (1.1% per year) than their white peers (1.8% per year).
“Latinas are less likely to be screened for breast cancer, so they are more likely to be diagnosed at later disease stages,” said Dr. Amelie Ramirez, director of the Institute for Health Promotion Research (IHPR) and the Salud America! program at UT Health San Antonio. “This makes it critical to improve breast cancer screening, prevention, and support for Latinas.”
What Is Breast Cancer?
Breast cancer is cancer that forms in the cells of the breasts.
After skin cancer, breast cancer is the most common cancer diagnosed in women in the United States. Breast cancer can occur in both men and women, but it’s far more common in women.
Signs and symptoms of breast cancer may include:
- A breast lump or thickening that feels different from the surrounding tissue
- Change in the size, shape or appearance of a breast
- Changes to the skin over the breast, such as dimpling
- A newly inverted nipple
- Peeling, scaling, crusting or flaking of the pigmented area of skin surrounding the nipple (areola) or breast skin
- Redness or pitting of the skin over your breast, like the skin of an orange
Doctors know that breast cancer occurs when some breast cells begin to grow abnormally. These cells divide more rapidly than healthy cells do and continue to accumulate, forming a lump or mass. Cells may spread (metastasize) through your breast to your lymph nodes or to other parts of your body.
Breast cancer most often begins with cells in the milk-producing ducts (invasive ductal carcinoma). Breast cancer may also begin in the glandular tissue called lobules (invasive lobular carcinoma) or in other cells or tissue within the breast.
Researchers have identified hormonal, lifestyle and environmental factors that may increase your risk of breast cancer. But it’s not clear why some people who have no risk factors develop cancer, yet other people with risk factors never do. It’s likely that breast cancer is caused by a complex interaction of your genetic makeup and your environment.
“The average risk of a woman in the United States developing breast cancer sometime in her life is about 13%,” the American Cancer Society states. “This means there is a 1 in 8 chance she will develop breast cancer. This also means there is a 7 in 8 chance she will never have the disease.”
What Is the State of Breast Cancer among Latinas?
Breast cancer is the most commonly diagnosed cancer among Latinas, with an estimated 24,000 cases expected to be diagnosed in 2018. The breast cancer incidence rate increased in Latinas from 2006 to 2015 (0.4% annually) while remaining stable in non-Latina white women, but remains 29% lower in Latinas.
Moreover, breast cancer is the leading cause of cancer death among Latinas, with an estimated 3,200 deaths expected in 2018.
From 2007 to 2016, breast cancer death rates decreased by 1.1% per year among Latino women and by 1.8% per year among white women. However, declines in Latinas younger than 50 appear to have stabilized in recent years.
There are countless reasons for the large gap in disparities.
For example, rates of cancer screenings—which can lead to much better cancer outcomes—are low across the board among Latinos. Other issues include systemic barriers that impact quality of care, such as a lack of access to medical insurance and a distrust of providers because of the small number of Latino physicians.
Moreover, systematic racism can also pose a challenge.
Luckily, there is hope for the future.
“Substantial support for breast cancer awareness and research funding has helped created advances in the diagnosis and treatment of breast cancer,” the Mayo Clinic states. “Breast cancer survival rates have increased, and the number of deaths associated with this disease is steadily declining, largely due to factors such as earlier detection, a new personalized approach to treatment and a better understanding of the disease.”
Something that has made a huge difference is cancer screening.
“Advances in screening and treatment for breast cancer have improved survival rates dramatically since 1989,” Medical News Today states. “According to the American Cancer Society (ACS), there are more than 3.1 million breast cancer survivors in the United States. The chance of any woman dying from breast cancer is around 1 in 38 (2.6%).”
Breast cancer mammography “has been shown to reduce deaths from the disease among women ages 40 to 74, especially those over age 50.”
Still, there is a racial gap.
The prevalence of mammography screening among women age 40 or older was 61% in Latinos, compared to 65% in whites.
The need to boost screening rates Latinos is critical.
So much so that organizations across the U.S. are trying new and exciting ways — including using targeted messaging in communities of color to raise screening rates.
One such initiative is NCI’s recent study that sent text and mail messages to raise rates of screening among Black people in Philadelphia.
“Among those in the study who received a single text message reminding them that they were overdue for colorectal cancer screening, only about 2% got screened in the next 12 weeks,” the report states. “But among those who were sent a series of text messages about getting screened and were mailed a fecal immunochemical test (FIT) to use at home, approximately 20% completed the test and returned it by mail over the same time period—a nearly 10-fold increase in screening completion.”
Are Clinical Trials an Option for Latinas?
Clinical trials help researchers create effective treatments or ways to manage diseases, or better understand illnesses.
A clinical trial can even help make it easier to Latinas to understand such trials.
For example, interactive videos featuring real Latina cancer survivors talking about clinical trials can help Latina breast cancer patients consider trials as a treatment option, according to a recent study led by Dr. Amelie Ramirez, leader of the IHPR and Salud America! program at UT Health San Antonio.
The study, published in Translation Behavioral Medicine in 2018, tested the videos with 77 Latina breast cancer patients at Mays Cancer Center at UT Health San Antonio.
Researchers randomly assigned 39 Latinas to a control group and 38 to a test group.
Then test group received “Choices,” a 30-minute interactive educational video program in English or Spanish about clinical trials and common barriers (delivered on a computer in the clinic). “Choices” also included a bilingual booklet and access to a patient navigator for care coordination. Control participants received usual care. Researchers surveyed all Latinas about clinical trials before and after.
After “Choices,” Latinas showed far greater understanding of clinical trials than controls.
More importantly, Latinas considering a clinical trial as a treatment option jumped from 52.8% before “Choices” to 86.1% after. Those who were aware of the risks and benefits but needed more information about clinical trials rose from 50% to 88.9%.
“Showing Latina breast cancer patients interactive, culturally tailored videos about clinical trials can help them hurdle any cultural barriers and consider trials as a positive treatment option,” Ramirez said.
Ramirez has led Latina-focused breast cancer research for over 20 years.
Ramirez currently has a National Cancer Institute study to fully understand the Latino cancer survivorship journey. Also, her Genentech-funded study aims to break down racial/ethnic barriers and increase Latino participation in cancer and Alzheimer’s clinical trials.
“Our Genentech support will allow us to use culturally relevant digital health communications, advocacy networks, and clinical partnerships to promote health equity and advance clinical trials for cancer treatment and Alzheimer’s disease among Latinos,” she said.
What You Can Do to Help
Latinas who experience breast cancer also need support.
That is why, Dr. Amelie G. Ramirez, leader of Salud America! and the Institute for Health Promotion Research at UT Health San Antonio, teamed with Susan G. Komen San Antonio to establish the Breast Friends Forever (BFF) support group in San Antonio, Texas.
The group meets bimonthly. You can email the BFF Support Group leaders.
Susan G. Komen, a leading breast cancer research and education organization, also has a web page dedicated to helping breast cancer survivors and family members find a support group.
“Support groups can be an important resource for people diagnosed with breast cancer,” according to Komen. “They help increase the support network of the people in the group.”
Salud America!, which is led by Dr. Ramirez, is sharing the stories of Latina cancer survivors.
Here are some of their stories:
- Myra Camino: ‘I Never Let Breast Cancer Steal my Joy’
- Tanya Enriquez DelValle: Keep Going, and Going, to Overcome Breast Cancer
- Mimi Frazier White: If We Fight Together, We Will Win Against Breast Cancer
- Ursula Garcia: What Breast Cancer Cannot Do
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