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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 S. 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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