CancerNetwork® spoke with Rachel A. Greenup, MD, MPH, an associate professor of surgery (oncology), section chief of Breast Surgery, and co-director of the Center for Breast Cancer at the Yale School of Medicine, about the rationale behind conducting a study evaluating the lived experiences among women of color following breast cancer mastectomy, as well as data collection strategies employed during the study and key themes outlined in questionnaire responses.

First, Greenup, senior author of the study, emphasized that disparities persist for women of color following mastectomy for breast cancer, both in those seeking breast reconstructive surgery and those choosing to forego it, which is an act called “living flat.” She explained that many of the stories behind these disparities were left untold, and this study was seeking to unearth them.

She then explained that women of color who underwent a mastectomy for breast cancer were sampled for the study. The patient population included women from her institution and survivors willing to share their experiences.

Expressing that her team strove to let the stories of these women speak for themselves, she discovered 2 major findings during her research. The first theme that emerged was a cultural stigma surrounding cancer diagnoses among minority groups, which impact knowledge of family history as well as timely screening, care, and support for their disease. The second major theme that her study revealed was spirituality as a driver for many of the decisions following mastectomy.

Greenup further emphasized a need for cultural, racial, and ethnic inclusion during clinical trials, which extends to anticipating differences in cancer developments among diverse populations. She concluded by encouraging all patients to share their family history of cancer, regardless of background, as it can impact screening and prevention measures.

“I would encourage all families and all individuals from different cultural backgrounds to share their family history of cancer. It has a critical impact in terms of screening and cancer prevention for other family members,” Greenup said. “It can be difficult to have those conversations, but it is information that can be powerful for future prevention.”

Khubchandani JA, Suttiratana SC, Washington R, et al. Living flat: stories from women of color after mastectomy. Ann Surg Oncol. Published online October 15, 2024. doi:10.1245/s10434-024-16337-y