title: Treatment experiences of Latinas after diagnosis of breast cancer.
abstract: BACKGROUND
  The authors examined racial/ethnic differences in patient perspectives regarding their breast cancer treatment experiences.
  
  
  METHODS
  A weighted random sample of women newly diagnosed with breast cancer between 2013 and 2015 in Los Angeles County and Georgia were sent surveys 2 months after undergoing surgery (5080 women; 70% response rate). The analytic sample was limited to patients residing in Los Angeles County (2397 women).
  
  
  RESULTS
  The pattern of visits with different specialists before surgery was found to be similar across racial/ethnic groups. Low acculturated Latinas (Latinas-LA) were less likely to report high clinician communication quality for both surgeons and medical oncologists (<69% vs >72% for all other groups; P<.05). The percentage of patients who reported high satisfaction regarding how physicians worked together was similar across racial/ethnic groups. Latinas-LA were more likely to have a low autonomy decision style (48% vs 24%-50% for all other groups; P<.001) and were more likely to report receiving too much information versus other ethnic groups (20% vs <16% for other groups; P<.001). Patients who reported a low autonomy decision style were more likely to rate the amount of information they received for the surgery decision as "too much" (16% vs 9%; P<.001).
  
  
  CONCLUSIONS
  There appears to be moderate disparity in breast cancer treatment communication and decision-making experiences reported by Latinas-LA versus other groups. The approach to treatment decision making by Latinas-LA represents an important challenge to health care providers. Initiatives are needed to improve patient engagement in decision making and increase clinician awareness of these challenges in this patient population. Cancer 2017;123:3022-30. © 2017 American Cancer Society.
authors.affiliation: Department of Internal Medicine, School of Medicine, University of Michigan, Ann Arbor, Michigan.|Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan.
authors.forename: Steven J
authors.identifier: http://orcid.org/0000-0002-1151-861X
authors.initials: SJ
authors.lastname: Katz
authors.affiliation: Department of Internal Medicine, School of Medicine, University of Michigan, Ann Arbor, Michigan.|Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan.
authors.forename: Lauren P
authors.identifier: http://orcid.org/0000-0002-1279-8617
authors.initials: LP
authors.lastname: Wallner
authors.affiliation: Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan.
authors.forename: Paul H
authors.initials: PH
authors.lastname: Abrahamse
authors.affiliation: Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan.
authors.forename: Nancy K
authors.initials: NK
authors.lastname: Janz
authors.affiliation: Center for Value-Based Care Research, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Martinez
authors.affiliation: Department of Radiation Oncology, School of Medicine, University of Michigan, Ann Arbor, Michigan.
authors.forename: Dean A
authors.initials: DA
authors.lastname: Shumway
authors.affiliation: Keck School of Medicine, University of Southern California, Los Angeles, California.
authors.forename: Ann S
authors.initials: AS
authors.lastname: Hamilton
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Ward
authors.affiliation: Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan.
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Resnicow
authors.affiliation: Department of Internal Medicine, School of Medicine, University of Michigan, Ann Arbor, Michigan.|Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan.|Veterans Administration Center for Clinical Management Research, Ann Arbor VA Health Care System, Ann Arbor, Michigan.
authors.forename: Sarah T
authors.initials: ST
authors.lastname: Hawley
mesh_terms: D000069:Acculturation; D000328:Adult; D001741:Black or African American; D000368:Aged; D001213:Asian; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D003142:Communication; D003657:Decision Making; D005260:Female; D057220:Health Literacy; D054625:Healthcare Disparities / Q000208:ethnology*; D006630:Hispanic or Latino; D006801:Humans; D015141:Los Angeles; D008408:Mastectomy; D015412:Mastectomy, Segmental; D008875:Middle Aged; D000072103:Oncologists; D017060:Patient Satisfaction; D026684:Personal Autonomy; D010817:Physician-Patient Relations; D018714:Radiotherapy, Adjuvant; D066231:Surgeons; D044465:White People; D055815:Young Adult
keywords: Latina health; Surveillance, Epidemiology, and End Results (SEER) epidemiology studies; breast cancer; population-based observational studies; treatment communication and decision making; women's health