In the United States, breast cancer continues to be the most common cancer diagnosed among women after non-melanoma skin cancer and is the second leading cause of cancer death (worldwide, it’s now the leading cause of cancer death). While there has been an overall 40 percent decline in breast cancer deaths over the last 30 years—thanks to progress in awareness, early diagnosis, and treatment—there is a persistent mortality gap between racial groups in the U.S.
Hispanic or Latino refers to individuals born in Latin America or whose ancestors were born in Latin America (Mexico, all countries in the Caribbean, Central, and South America) and have continental ancestral backgrounds (mostly European, Indigenous American, and African, and to a lesser extent, Asian). Until recently, the diversity within this population had not been systematically addressed in cancer research. The lack of data breaking down subgroups of Hispanics and Latinos has resulted in these individuals of varied racial backgrounds being considered as one category.
Here, we outline how these communities are impacted by breast cancer and how research can improve outcomes for Hispanic women and Latinas.
Hispanic women and Latinas are not homogeneous, and the risk of developing breast cancer among these women varies by national origin and genetic ancestry. In the U.S., breast cancer incidence in the overall group is 28 percent lower than in non-Hispanic white women, who have the highest incidence rate, according to recent data from the American Cancer Society.
While this statistic seems encouraging, breast cancer is still the leading cause of cancer deaths in these populations, as in all women. Although Latin America is genetically diverse, Hispanic women and Latinas are more likely to be diagnosed at a younger age and with more aggressive disease such as triple-negative breast cancer, which has fewer targeted treatments. They are also diagnosed at more advanced stages and are about 30 percent more likely to die from their breast cancer than their non-Hispanic white counterparts.
Many complex and interconnected factors contribute to racial disparities in breast cancer development and outcomes. These factors include genetics, lifestyle, access to healthcare, social determinants of health, and limited research conducted in people of color. Data make clear that advances in treatment that have dramatically reduced breast cancer mortality have not equally benefited all groups.
Hispanics and Latin Americans are less likely to receive screening for BRCA mutations compared to other populations worldwide. Studies thus far, however, find that women in many regions of Latin America have higher BRCA mutation incidence with specific mutations frequently seen in the population, as well as differences in how their breast cancer behaves. To date, research has found no difference in treatment response rates between Hispanic women and Latinas and other ethnic groups.
Social determinants also significantly influence overall health because they impact nearly every aspect of care, including access to insurance, preventive care, and treatment. Hispanic women and Latinas are disproportionately affected by these factors, which is reflected in the lower rates of screening mammography among this group. Regular screening mammograms are considered to be one of the most reliable methods to detect breast cancer in its early stages. While breast cancer screening has increased across all racial and ethnic groups, Hispanic women and Latinas are still less likely to be diagnosed with early-stage breast cancer, partially due to infrequent mammograms or lack of follow-up on abnormal screening results. This delay results in more advanced breast cancer at the time of diagnosis. Explanations for lapsed mammography could include inadequate health insurance coverage, limited access to care, lack of knowledge of the healthcare system, or language barriers.
Lifestyle can play a critical role in breast cancer prevention. Hispanic women and Latinas in the U.S. have a higher incidence of breast cancer than their counterparts living in Latin America, most likely due to lifestyle changes. Diets rich in vegetables, fruits, whole grains, and low in red meat and alcohol—like the traditional diets of many ethnic groups in Latin America—have consistently been associated with a decreased risk of breast cancer. Consuming a more American diet by choice or because of lack of access to fresh foods—and associated weight gain—may be responsible for this discrepancy in breast cancer risk among Hispanic women and Latinas, particularly after menopause.
BCRF recognizes the continued need for research that eradicates disparities and improves outcomes for all by fostering innovative and collaborative science. BCRF investigators are working to understand the differences in breast cancer biology across racial and ethnic groups and are making strides to reduce the risk of breast cancer for all women.
While we have made significant progress in understanding drivers of breast cancer, most studies and clinical trials are in non-Hispanic white women. Increasing participation of underrepresented groups provides an opportunity to gain valuable insights into tumor biology and its variations among all people. This will ultimately enable the development of more personalized therapies and improve outcomes for Hispanic women and Latinas diagnosed with breast cancer.
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