title: Racial/ethnic disparities in knowledge about one's breast cancer characteristics.
abstract: BACKGROUND
  Understanding tumor characteristics is likely important, but little is known about breast cancer patients' knowledge of their own disease. The authors assessed women's knowledge about their tumor characteristics, whether racial/ethnic disparities in knowledge exist, and whether education and health literacy influence associations.
  
  
  METHODS
  A population-based cohort of women in Northern California with stage 0 through III breast cancers diagnosed from 2010 to 2011 (participation rate 68.5%) was surveyed. Among 500 respondents (222 non-Hispanic white women, 142 non-Hispanic black women, and 136 Hispanic women), racial/ethnic differences in knowledge about tumor characteristics (estrogen receptor [ER] status, human epidermal growth factor receptor 2 [HER2] status, stage, grade) and correctness of tumor information (with California Cancer Registry data for confirmation) were examined. Multivariate logistic regression was used to assess the probability of: 1) knowing tumor stage, receptor status, and grade; and 2) correctly answering questions about tumor information by race/ethnicity. The impact of education and health literacy on findings was examined in sequential models.
  
  
  RESULTS
  Overall, 32% to 82% of women reported knowing each of the 4 tumor characteristics of interest, and 20% to 58% correctly reported these characteristics. After adjustment, black and Hispanic women were less likely than white women to know and have correct responses for stage, ER status, and HER2 status (all P<.05). Education and health literacy were significantly associated with knowing and having correct information about some characteristics, but these variables did not eliminate most of the racial/ethnic differences observed.
  
  
  CONCLUSIONS
  Patient's knowledge about their own breast cancer was generally poor, particularly for minority women. Further study of how this knowledge may impact receipt of care and outcomes is warranted.
authors.affiliation: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Freedman
authors.forename: Elena M
authors.initials: EM
authors.lastname: Kouri
authors.forename: Dee W
authors.initials: DW
authors.lastname: West
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Keating
mesh_terms: D001741:Black or African American; D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology*; D015331:Cohort Studies; D003625:Data Collection; D005260:Female; D006266:Health Education / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D057220:Health Literacy / Q000706:statistics & numerical data*; D006630:Hispanic or Latino; D006801:Humans; D008875:Middle Aged; D008913:Minority Groups; D054525:Minority Health; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D012959:Socioeconomic Factors; D044465:White People
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; C508053:ERBB2 protein, human
keywords: breast cancer; disparities; education; health literacy; knowledge