Girls with family history of breast cancer have higher self-esteem
Breast cancer is the leading cause of cancer deaths among Latinas, yet women of Latin American descent are still less likely to get regular mammograms.
Doctors worry that access to healthcare and education accounts for this discrepancy, which impacts residents of low-income neighborhoods more than their wealthier neighbors. Hispanic women continue to be less likely to receive appropriate and timely breast cancer treatment in comparison to non-Hispanic whites, according to Cancer.org. This means Latinas are frequently diagnosed with more advanced breast cancers than white women due to lower mammography rates and more delays in treatment after an abnormal mammogram.
Although lack of health insurance is a main reason for breast cancer screening disparities in the U.S., other factors play a role. Even among women with insurance, only 70 percent had a recent mammogram, according to the Susan G. Komen organization.
Intervention programs that follow patients throughout treatment have been shown to reduce these disparities by more than half. But getting women into screening remains an issue of access and willingness.
Dr. Angela R. Bradbury at the University of Pennsylvania’s Abramson Cancer Center says one way to ease discomfort around the subject is to talk to young women about breast cancer at an early age. Through a recent study sponsored by the university, Bradbury found that teenage girls with a family history of breast cancer do not experience increased anxiety or depression. This should alleviate concerns parents might have about discussing their own diagnosis with their children.
“Overall, girls in families with a history of breast cancer seem to cope pretty well over time,” she says. “They do worry more about breast cancer than their peers do, particularly as they get older, but that doesn’t seem to impact them in terms of depression, anxiety, and general psychosocial adjustment.”
The new research followed 320 girls between the ages of 11 and 19 years old. More than 200 of them are from families with a history of breast cancer. The researchers interviewed the girls and their birth mothers, and routinely administered tests to assess their psychosocial adjustment, perception of breast cancer risk and breast cancer-specific distress.
Bradbury, the study’s lead author, was especially concerned with the idea of screening girls at a younger age. There is some debate in the medical community over when women should start actively screening for breast cancer. The U.S. Preventive Services Task Force recommends biennial mammograms for women aged 50 or older. These guidelines stirred controversy when they first emerged several years ago among doctors who say waiting until middle age puts too many women at risk. The American Cancer Society offers a different set of guideline – they recommend women start considering annual mammograms when they turn 40 years old. By the age of 45, women should be screened yearly and twice yearly by the age of 55.
But Bradbury’s team remains interested in whether screening younger women could save lives in the long run. She says these recent tests that analyze the emotional burden of talking about breast cancer to teenagers is a first step in examining when women should begin their personal journey.
“A lot of the concerns going into this study … is that girls [with a family history of breast cancer] would be struggling emotionally,” she says. “But it is possible that girls with cancer in the family may have to develop life skills and coping strategies and may higher self-esteem than their peers.”
For all the girls in the study, perceptions of breast cancer risk rose as they grew older and matured mentally, and in terms of breast development. But the perceived risk was always higher among the girls with a breast cancer family history.
“Girls from breast cancer families do worry more about breast cancer than their peers do, and that’s not really surprising,” Bradbury said. “We don’t have evidence yet that that worry is a harmful thing; it may even be a motivating factor to adopt a healthier diet or to exercise more.”
Bradbury’s study is the first of its kind, however she admits to certain limitations. The group was largely drawn from current patients or people in the university’s immediate neighborhood, resulting in a homogenous cohort when you account for race, income and education. Anglo women and those with higher incomes are already shown to be more inclined to seek medical help with they need it and screen for cancer more regularly.
“We would really like to see a more diverse population,” she says. “There are a lot of populations that never have access to genetic testing whether it’s because it’s mostly done at university centers or there aren’t many doctors who provide the service.”
Until medical programs expand their reach, many of these services remain highly elusive to residents outside of research corridors.