An alarming 51% of women failed to seek out medical care after detecting a change in their breasts through self-examination, in a study of 314 Mexican American women with invasive breast cancer.
The most common method of breast cancer detection was self-exam (68%), which included routine breast exam and incidental self-discovery, followed by screening mammography (22%), clinical exam by a health professional (6%), and other methods (5%) (percentages are rounded).
The study was reported by Rachel Zenuk and her associates in a poster at a conference sponsored by the American Association for Cancer Research.
After noticing a change in their breasts, 159 of the women reported waiting a month or more before seeking medical attention.
Of these, 143 waited 1–11 months and 16 patients waited 1 year or more.
The most common reasons for prolonging medical care were the following: They “did not feel it was important” (33%), they did not have insurance (31%), they were afraid (13%), and their physicians did not have any earlier appointments (12%).
The low rate of mammography screening in the Hispanic women in this study stands in sharp contrast to rates of 70%–80% reported among Hispanics in national surveys such as the Breast Risk Factor Survey, Ms. Zenuk, a graduate student at the University of Arizona Cancer Center in Tucson, told reporters at a press briefing.
However, previous studies have demonstrated that large ethno-regional differences in breast cancer screening rates exist among Hispanic groups across the country, with less than 50% of Mexican American women in Texas border regions reporting having received recent mammograms (Health Educ. Res. 2000;15:559–68).
Ms. Zenuk and her associates evaluated a variety of sociocultural factors that might have influenced mammography utilization in their cohort.
Women aged 25–86 years (median 49 years) were recruited from Houston and various Arizona cities and completed the ELLA Risk Factor Questionnaire via interviews in English and Spanish.
At the time of the interview, 264 of the 314 women were aged 40 or older. Among these women, 72% reported undergoing prior mammography.
Significant differences in mammography screening were observed between women who reported high English language use (85%) and those with lower use (59%), the investigators reported.
Those with a high school degree or higher were also significantly more likely to have received prior mammography versus those with lower levels of education (77% vs. 64%).
The same was true of Mexican American women born in the United States (85%), compared with those born outside the United States (63%).
A majority of the Mexican American women in this study (73%) reported high exposure to Spanish media, suggesting a way to improve culturally appropriate beast cancer screening education, including information about affordable medical programs in their communities, the authors wrote.
“We're definitely thinking that we have to develop an intervention model that addresses these complex issues, including prompt detection and reporting” when breast changes are detected, Ms. Zenuk told reporters.
The study is part of the ELLA Binational Breast Cancer Study, which is funded by the National Cancer Institute and the Avon Foundation.
The investigators reported no conflicts of interest.