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Surgical Treatment Differences Among Latina and African American Breast Cancer Survivors

Maureen Campesino
Mary Koithan
Ester Ruiz
Johanna Uriri Glover
Gloria Juarez
Myunghan Choi
Robert Krouse
ONF 2012, 39(4), E324-E331 DOI: 10.1188/12.ONF.E324-E331

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-methodsstudy 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.

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