Oct 8, 2010

Breast Cancer Risk Factors Vary According to Acculturation Level

Miami, Florida-Some risk factors for breast cancer among women of Mexican descent vary according to their level of acculturation, researchers said here at the Third American Association for Cancer Research Conference on the Science of Cancer Health Disparities.

The study, called the Ella Binational Breast Cancer Study, separated more than 1000 women with recently diagnosed invasive breast cancer”606 Mexican women and 488 Mexican-American women”into 3 main groups: those whose language was English-dominant, those considered bilingual, and those who were Spanish-dominant. A very small number were found to be marginalized, speaking both little Spanish and little English.

Researchers said language is considered the single strongest predictor of acculturation.

Researchers found that Mexican-American women who were English-dominant”considered the group most acculturated to the United States”were the least likely to have ever breast-fed (35%) of the 4 groups. They were followed by the Mexican-American bilingual group (56%); the Mexican-American, Spanish-dominant group (70%); and the Mexican group (80%; .0001).

Studies have suggested that breast-feeding might slightly lower breast cancer risk.

Researchers found a similar trend for the number of live births the women had. The Mexican-American, English-dominant group had an average of 2.6 live births; the Mexican-American bilingual women had an average of 3.1 births; the Mexican-American, Spanish-dominant women had an average of 3.7 births; and the Mexican-born women had an average of 3.9 births (P < .0001).

Having children has been found to reduce the risk for breast cancer.

“Given the recent data supporting distinct correlations between risk factors and tumor subtypes, it will be essential to consider acculturation and other measures of cultural context when assessing the association between risk factors and distinct subtypes,” said Rachel Zenuk, a predoctoral fellow in the University of Arizona’s Department of Epidemiology in Tucson.

The study involved 8 centers in Arizona, Texas, and Mexico. The women had been diagnosed within the previous 24 months.

Age at first menstrual period decreased with the level of acculturation, researchers found. Breast cancer risk tends to rise in women with earlier first menstrual cycles (P <.001).

There were no differences found for age at first pregnancy or age at menopause. There were also no differences found for body mass index or physical activity levels.

Although the data might be interesting, such findings may not be likely to alter a physician’s approach, said Levi Garraway, MD, PhD, assistant professor in the Department of Medicine at Harvard Medical School in Boston, Massachusetts, who moderated the session.

“Most of the risk factors for which she showed data are risk factors that are fairly well-established, so probably those doctors are going to be asking about those things anyway,” he said.

However, such studies might raise cultural awareness.

“If somebody is Mexican-American or Spanish-[speaking] only,” Dr. Garraway said, “it may be that you are more likely to add a translator or a navigator to their care.”

Ms. Zenuk and Dr. Garraway have disclosed no relevant financial relationships.

Third American Association for Cancer Research Conference on the Science of Cancer Health Disparities: Abstract PR-5. Presented October 1, 2010.

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