Best practices for reducing breast cancer disparities

In 2012, cancer became the leading cause of death for Latinos, with breast cancer remaining the leading cause of cancer mortality among Latinas, who are more likely to be diagnosed with more aggressive, premenopausal breast cancers at later stages compared to non-Hispanic white women. Along with suggested decreases in clinical- and self-breast exams, revised guidelines – based on studies of predominantly non-Hispanic white women – delay screening by ten years; therefore we project an increase in breast cancer disparities, and ultimately mortality, that disproportionately affects Latinas. Eleven years of linked data from the National Health Interview Survey and the Medical Expenditure Panel Survey show that rates of clinical breast exams start to decrease between 2007-2008, with mammography rates decreasing for Latinas in 2010. Before 2008, about 44% of breast cancers in women age 40-49 were detected by mammograms; however, with the implementation of the new screening guidelines these cases may not be detected as quickly, leading to a later stage diagnosis for some women. Factoring national rates of self-breast exam at less than 30%, and expected sensitivity and specificity of these methods of breast cancer screening, we project breast cancer mortality among Latinas is alarmingly expected to increase by as much as 10%. With most breast cancers cited as being discovered through self-exam or other incidental findings, considerations for best practices for the early detection and diagnosis of breast cancer among Latinas are revisited.