City of Hope Investigators Find Young Breast Cancer Survivors Understudied and Underserved 

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In interacting with young survivors, we observed the presence of heightened fear and uncertainty, yet tremendous energy, creativity, and talents.

—Kimlin Ashing-Giwa, PhD

Researchers at City of Hope National Medical Center in Duarte, California, have been studying the effects of breast cancer on young women, particularly ethnic minorities and lower socioeconomic populations. They have found that young women are increasingly being diagnosed with breast cancer, yet remain understudied and underserved. Specifically, more exploration needs to be done into how health-care providers can improve follow-up care among minority survivors. The team hopes that examining age-specific factors and the particular medical and psychosocial vulnerabilities of this group will result in improved care.

“The study findings suggest that examining ethnic and linguistic factors among younger survivors is necessary to better address their specific needs, including appropriate and timely high-quality care for ethnic minority young breast cancer survivors,” said ­Monica Rosales, PhD, at the 10th Annual Conference of the American Psychosocial Oncology Society (APOS), held recently in Huntington Beach, California.1

Study Design

African American, English-language-preferred Latina, and Spanish-language-preferred Latina breast cancer survivors under 50 years old participated in the study. All were within 1 to 6 years of their breast cancer diagnosis, which ranged from stage 0 to III. They were recruited from the California Cancer Registry and hospital registries.

“In interacting with young survivors, we observed the presence of heightened fear and uncertainty, yet tremendous energy, creativity, and talents,” said Kimlin Ashing-Giwa, PhD. “These women are very motivated to work with clinicians and researchers to advance the science and practice for improved outcomes and well-being.”

The researchers examined satisfaction of young breast cancer survivors with their care, specifically examining where their treatment took place. Those who had a regular medical home they went to when feeling sick and for preventive and follow-up care were contented with their treatment. Those who received care at a doctor’s office, rather than an urgent care facility, reported greater patient satisfaction. Spanish-speaking Latinos were less likely to report having a medical home. This is likely because they struggle to find affordable health-care coverage and resources available in their native language.

First Study of Its Kind

“Ours is the first study to report on demographic and medical characteristics and satisfaction with care among African American and Latina young breast cancer survivors,” Dr. Rosales said. “As the ethnic minority breast cancer survivor population increases, investigating the experience of ethnic and linguistic minorities among young breast cancer survivors, to better understand their follow-up care and satisfaction with their care, can contribute to efforts to improve survivorship outcomes.”

Moving forward, the researchers want to examine the most urgent follow-up care needs of young breast cancer survivors’ and improve survivorship by designing intervention studies to meet those needs and promote adherence to follow-up care guidelines. They also want to create a treatment and survivorship care plan that is tailored to this underserved population.

“Unfortunately, breast cancer among premenopausal women seems to be on the increase, especially among ethnic minority women,” Dr. Ashing-Giwa said. “When breast cancer occurs in young women, the medical, physical, psychosocial, and overall impacts can be more severe. Greater research and clinical attention must be given to this at-risk population.” ■

Disclosure: Drs. Rosales and Ashing-Giwa reported no potential conflicts of interest.


1. Rosales M, Ashing-Giwa K: Young breast cancer survivors’ quality of care. Abstract P2-15. 2013 American Psychosocial Oncology Society Annual Conference, Presented February 16, 2013.