When it comes to breast cancer, Hispanic women or Latinas are more likely to be diagnosed at more advanced stages, which are more difficult to treat. They are also more likely to have aggressive forms of the disease, such as triple-negative and HER2-positive breast cancer.
Laura Fejerman, PhD, is among those working to increase breast cancer awareness and screening among Hispanic or Latina women. She is co-director of the Women’s Cancer Care and Research Program at UC Davis Comprehensive Cancer Center. In 2014, Fejerman and her colleagues discovered a gene variant in Hispanic women, or Latinas, that was thought to have been inherited from their Indigenous American ancestors. This protective variant appears to play a role in reducing the risk of breast cancer. But all Hispanic women or Latinas still need to keep up with regular breast cancer screening and have any lumps or breast lesions examined by a doctor.
Fejerman started Tu Historia Cuenta, or Your Story Matters, a breast cancer awareness program. It includes the importance of knowing your family history (although not all breast cancer runs in families, a family history of the disease is a risk factor) and talking about a topic that some may find uncomfortable.
“If your grandma had cancer and your aunt had cancer and your cousin has cancer, that’s really important for your own health,” says Fejerman.
“People don’t like to tell family members they have cancer or share it with friends because they either feel it is a burden on them or they are embarrassed, especially when it comes to gynecological or breast cancer acts,” she says. “It kind of stays in a very private circle.”
Your Story Matters works with Spanish-speaking health educators to educate women about breast cancer. In the past two years, the program has reached about 1,300 Hispanic or Latina women in California through online and face-to-face classes, Fejerman says. The program sponsors mammography screening, as well as genetic screening and counseling when women have a significant family history of the disease.
Genetic screening can inform women if they have an increased risk of breast cancer. It’s not for everyone – it’s usually recommended for those at risk. But Hispanic women or Latinas are less likely to get this testing and counseling, Fejerman says, noting that they often don’t know or don’t have these services insurance that covers it.
The COVID-19 Pandemic “The Hispanic community and other communities of color were disproportionately affected,” according to the American Cancer Society’s Cancer Facts and Figures for Hispanic/Latino People: 2021-2023 report.
“A lot of people missed their routine checkups,” says Darcie Green, director of Latinas Contra Cancer (LCC), a service and advocacy group in San Jose, Calif. that helps low-income Hispanic women or Hispanic clients with cancer issues. LCC’s work includes providing health education to reduce the risk of cancer and assisting its clients in completing mammography screenings. (Screening mammograms are routine examinations of the breasts. Diagnostic mammograms are done when there is a specific breast problem, such as a lump.)
But it’s not just the pandemic. Underserved Latinas routinely face health disparities when seeking a mammogram, Green notes.
Women with insurance who know how to get around health care System can easily book a mammography appointment, drive to the facility, and get checked out. In contrast, many LCC customers face greater hurdles, particularly in an expensive urban area where families find it harder to survive economically.
They may not be able to afford unpaid time off work to review something they are concerned about, Green points out. “You can be the breadwinner in your home. They may have multiple generations in their household.”
Underserved Hispanic women or Latinas may also have trouble making an appointment if they don’t have a primary care doctor or gynecologist. They may have other barriers, such as childcare issues, long travel times, or reliance on public transportation, Green says. To address these obstacles, LCC can help customers make appointments or arrange transportation.
Women who are uninsured or underinsured can still get a mammogram. In each state, the state-run National Breast and Cervical Cancer Screening Program can help low-income, uninsured, or underinsured women ages 40 to 64 get a mammogram for little or no cost.
Mammograms alone do not diagnose breast cancer. A biopsy is required for a diagnosis. But screening mammograms are an important part of early detection, which can be life-saving because they can detect a cancer before it has spread. You may not feel it yet.
It’s also important to talk about breast health. To discuss breasts can be uncomfortable, says Green. LCC is trying to normalize the conversation and raise women’s awareness—not just about getting mammograms, but about checking for lumps, wrinkles, redness, and other changes that require medical attention. “Knowing your breasts, knowing your body, is really important,” says Green.