Receipt of diagnostic tests for breast cancer: validity of self-reports among low-income, mostly latina, indigent women

Psychological Outcomes After a False Positive Mammogram: Preliminary Evidence for Ethnic Differences Across Time

Adverse psychological consequences of screening mammography are well-documented for women who receive a false positive result. However, little is known about ethnic differences. To address this gap, we examine distress associated with an abnormal mammogram (results-related distress) and perceived lifetime risk of breast cancer (perceived risk) among Latinas and non-Latina White (NLW) women 3 months after receipt of a false positive result. A sample of 28 Latina and 27 NLW women who received an initial abnormal mammogram result and later, a definitive non-cancer diagnosis were recruited for this descriptive, longitudinal study. Women were interviewed twice: within 30 days and 3 months after a false positive result. Questionnaires included standard sociodemographic questions, the Impact of Events Scale-Revised, and two perceived breast cancer risk items. All participants experienced decreased distress 3 months after the initial results. Latinas experienced higher levels of distress, F(1,45) = 4.58, p = 0.04, and had a significant increase in perceived breast cancer risk over time, F(1,45) = 3.99, p = 0.05. Larger population-based studies are necessary to confirm ethnic differences in mental health consequences of false positive results. Given cultural emphases concerning respect for authority figures, healthcare professionals may be particularly helpful in working with Latinas to mitigate distress and clarify accurate perceptions of breast cancer risk through evidence-based practice.

Self-Report Versus Medical Record for Mammography Screening Among Minority Women

Self-report is the most common means of obtaining mammography screening data. The purpose of this study was to assess the accuracy of minority women's self-reported mammography by comparing their self-reported dates of mammograms with those in their medical records from a community-based randomized control trial. We found that out of 192 women, 116 signed the Health Information Portability and Accountability Act form and, among these, 97 had medical records that could be verified (97 / 116 = 83.6%). Ninety-two records matched where both sources confirmed a mammogram; 48 of 92 (52.2%) matched perfectly on self-reported date of mammogram. Complexities in the verification process warrant caution when verifying self-reported mammography screening in minority populations. In spite of some limitations, our findings support the usage of self-reported data on mammography as a validated tool for other researchers investigating mammography screening among minority women who continue to have low screening rates.

Understanding the patient-provider communication needs and experiences of Latina and non-Latina White women following an abnormal mammogram

Latinas are more likely to delay recommended follow-up care than non-Latina White (NLW) women after an abnormal mammogram result. Ethnic differences in communication needs and experiences with health-care staff and providers may contribute to these delays as well as satisfaction with care. Nonetheless, little research has explored the aspects of communication that may contribute to patient comprehension, adherence to follow-up care, and satisfaction across ethnicity. The purpose of this exploratory, qualitative study was to identify patients' communication needs and experiences with follow-up care among Latina and NLW women who received an abnormal mammogram. We conducted 41 semi-structured interviews with 19 Latina and 22 NLW women between the ages of 40 and 74 who had received an abnormal mammogram. Communication themes indicated that women's needs and experiences concerning abnormal mammograms and follow-up care varied across ethnicity. Latinas and NLW women appeared to differ in their comprehension of abnormal results and follow-up care as a result of language barriers and health literacy. Both groups of women identified clear, empathic communication as being important in patient-provider communication; however, Latinas underscored the need for warm communicative styles, and NLW women emphasized the importance of providing more information. Women with high levels of satisfaction with patient-provider interactions appeared to have positive perspectives of subsequent screening and cancer treatment. To improve patient satisfaction and adherence to follow-up care among Latinas, educational programs are necessary to counsel health-care professionals with regard to language, health literacy, and empathic communication needs in health-care service delivery.

Breast cancer interventions serving US-based Latinas: current approaches and directions

Despite efforts to reduce morbidity and mortality in breast cancer, Latinas continue to have lower 5-year survival rates than their non-Latina white counterparts. All along the cancer continuum from screening to follow-up of abnormal screening to diagnosis and treatment to survivorship, Latinas fare poorer than non-Latina whites. To close this gap, a number of research projects across the continuum have attempted to improve breast cancer outcomes. In this review, we examine studies that have been carried out in breast cancer along the cancer continuum. We focus not only on randomized, controlled trials, but also on quasi-experimental, and pre- and post-test studies that provided interventions for positive breast cancer outcomes. We examine not only the intervention outcomes, but also the type of intervention targets and type of intervention implementation. In future breast cancer research among Latinas, more emphasis should be placed on the steps in detection and treatment that occur after screening.