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William J. Gradishar, MD, FACP, FASCO
William J. Gradishar, MD, FACP, FASCO
Posted: Monday, December 9, 2024
Cultural factors including breast cancer stigma and spirituality appear to be key contributors to quality of life among women of color who undergo mastectomy but not breast reconstruction, according to research published in the Annals of Surgical Oncology. Reporting the results of their community-based, participatory study, Rachel A. Greenup, MD, MPH, of Yale Cancer Center, Yale School of Medicine, New Haven, Connecticut, and colleagues stressed that these domains are seldom included in contemporary patient-reported outcome measures, and that better representation of diverse experiences is needed to achieve equity in breast cancer treatment.
“Our team-based approach allowed us to learn from women of color regarding their rich experiences with living flat after mastectomy,” said Dr. Greenup in a Yale Cancer Center/Smilow Cancer Hospital press release. “These untold stories identified key aspects of the breast cancer journey that are not routinely addressed in shared decision-making nor included in validated outcome measures. Inclusive patient-centered cancer care must address physical, emotional, sociodemographic, and cultural well-being.”
A total of 20 women aged 18 or older who underwent mastectomy without reconstruction for breast cancer were included in the study, of whom 60% identified as Black, 20% as Asian, 10% as multiracial, 5% as Latina, and 5% as White. Participants completed a sociodemographic and health questionnaire, and they took part in virtual interviews conducted by formally trained community-based research fellows using an interdisciplinary interview guide. Key elements discussed included cancer stigma, breast privacy concerns, the importance of support through shared experiences, the sacrifice of breasts for life and health, spirituality, impact on family relationships, and societal expectations.
“Our findings suggest that public accounts of living flat after mastectomy do not reflect the physical, psychosocial, and interpersonal sequelae experienced by women of color,” the investigators added. “Incorporation of culturally tailored support holds promise to improve cancer treatment decisions and long-term health-related quality of life.”
Disclosure: For full disclosures of the study authors, visit springer.com.
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