Method of Detection of Breast Cancer in Low-Income Women

Abstract

Background: Breast cancer is the most common malignancy among women, and its timely diagnosis and treatment are of paramount importance, especially for vulnerable groups, such as low-income and uninsured women. Recent literature confirms that the method of breast cancer detection may be an important prognostic factor, but there are no studies that examine the method of breast cancer detection in low-income populations. We sought to analyze the determinants of method of detection (medical vs. self) in a cohort of low-income women with breast cancer receiving care through California's Breast and Cervical Cancer Treatment Program. Methods: This is a cross-sectional survey analysis of 921 low-income women interviewed within 6 months of definitive surgical treatment. The outcome analyzed was self vs. medical detection of breast cancer. Results: The mean age of the women was 53 years, with nearly 88% reporting an income of <$30,000 per year; 64% of women self-detected their breast cancer. Logistic regression analyses revealed that older women, Latinas, and women having any health insurance before diagnosis had lower odds of self-detecting their lesions. Conclusions: Patient age, ethnicity, and regular source of care were associated with method of breast cancer detection in a low-income underserved population. The rate of self-detection in our population correlates with the literature, but we need to improve efforts to increase mammography screening to ensure early detection of disease in this vulnerable group.

Self-Detection Remains a Key Method of Breast Cancer Detection for U.S. Women

“…Data from a study of women receiving care through California's Breast and Cervical Cancer Treatment Program showed that 64% of women self-detected their breast cancer. 22 Our findings are also similar to those reported from Finland, which has a 90% participation rate in mammography screening programs. 23 Even in the Finnish population, however, the percentage of breast cancers found by screening mammography was only 21% for the entire population and only 41% among women aged 50-69 years at diagnosis.…”

What Influences Diagnostic Delay in Low-Income Women with Breast Cancer?

“…As we previously reported, 41 a majority (about 67%) of the women self-detected their breast abnormality. Women who did so were markedly more likely to experience diagnostic delays than those whose abnormalities were system-detected, potentially putting them at increased risk for mortality.…”

“Everything Happened So Quickly” Living Through Events Immediately Before and After Initial Breast Cancer Diagnosis: An Exploratory Study of the Experiences of a Group of Women in Cape Town, South Africa

“…This finding correlates with a previous study which reported that "a vast majority of breast cancers are found by women themselves" [29]. Thind, Diamant, Hoq and Maly [30] also note that it is more common for women to detect their breast cancer themselves and this is especially common among women who have no medical insurance or who do not have regular access to health care prior to diagnosis. Some of the women discovered the lump accidentally while others discovered it through regular self-examination.…”