Surgical treatment differences among Latina and African American breast cancer survivors.

PURPOSE/
OBJECTIVES: To describe breast cancer treatment choices from the perspectives of Latina and African American breast cancer survivors.
DESIGN: An interdisciplinary team conducted a mixed-methods study of women treated for stages I-IV breast cancer.
SETTING: Participants' homes in metropolitan areas. SAMPLE: 39 participants in three groups: monolingual Spanish-speaking Latinas (n = 15), English-speaking Latinas (n = 15), and African American women (n = 9).
METHODS: Individual participant interviews were conducted by racially and linguistically matched nurse researchers, and sociodemographic data were collected. Content and matrix analysis methods were used. MAIN RESEARCH VARIABLES: Perceptions of breast cancer care.
FINDINGS: High rates of mastectomy were noted for early-stage treatment (stage I or II). Among the participants diagnosed with early-stage breast cancer, the majority of English-speaking Latinas (n = 9) and African American women (n = 4) received a mastectomy. However, the majority of the Spanish-speaking Latina group (n = 5) received breast-conserving surgery. Four factors influenced the choice of mastectomy over lumpectomy across the three groups: clinical indicators, fear of recurrence, avoidance of adjuvant side effects, and perceived favorable survival outcomes. Spanish-speaking Latinas were more likely to rely on physician treatment recommendations, and the other two groups used a shared decision-making style.
CONCLUSIONS: Additional study is needed to understand how women select and integrate treatment information with the recommendations they receive from healthcare providers. Among the Spanish-speaking Latina group, limited English proficiency, the use of translators in explaining treatment options, and a lack of available educational materials in Spanish are factors that influenced reliance on physician recommendations. IMPLICATIONS FOR NURSING: Oncology nurses were notably absent in supporting the women's treatment decision making. Advanced practice oncology nurses, coupled with language-appropriate educational resources, may provide essential guidance in clarifying surgical treatment choices for breast cancer among culturally and linguistically diverse populations.