Cancer Health Literacy in Black Women With Breast Cancer: A Comprehensive Literature Review.

BACKGROUND: Patients with cancer have unique health literacy needs that affect health outcomes. In regard to breast cancer, Black women are more commonly diagnosed with high-grade breast tumors and have increased mortality rates. OBJECTIVES: This review examines the role of health literacy and discusses health disparities that affect cancer health literacy and health behaviors in Black women with breast cancer. METHODS: A literature search was conducted using CINAHL®, PubMed®, Ovid®, and Google Scholar™. A total of 12 studies were identified and included in the final review. FINDINGS: Women with breast cancer in racial minority groups are less likely to report knowing or answering questions correctly for multiple tumor characteristics, have a lower quality of life related to low health literacy levels, and are at an increased risk for inadequate health literacy because of socioeconomic inequities. Unmet health literacy needs can potentially to lead to poor self-management, poor medication adherence, increased hospitalizations, negative perceptions of health, and compromised quality of life.

Psychosexual responses to BRCA gene mutations in women of childbearing age.

BACKGROUND: Diagnosis of a BRCA gene mutation presents a dilemma because life-changing medical decisions must be made to prevent breast and ovarian cancer. There is minimal evidence regarding how psychosexual functioning, psychological well-being with regard to body image and sexuality, affects the decision to have prophylactic treatment in women of childbearing age (WCBA; 18-49 years) with a BRCA gene mutation. PURPOSE: To explore, describe, and interpret the experience of women with a BRCA mutation during the treatment and decision-making process. METHODOLOGY: A qualitative descriptive design was used to recruit participants online through social media postings and from national and local BRCA support groups. Participants participated in semistructured interviews exploring their experience after BRCA diagnosis. Interpretive descriptive analysis was used to identify themes. RESULTS: The purposive sample comprised 18 women aged 21-49 years. Four major themes, such as body image, sexuality, femininity, and childbearing/childrearing, were identified that influenced decisions related to the diagnosis and management of a BRCA mutation. All participants voiced that concerns regarding body image and sexuality caused hesitancy in their decision to have prophylactic surgery. Women who had undergone bilateral prophylactic mastectomy were concerned about the impact of the surgery, scarring, breast disfigurement, and the lack of sensation resulting from surgical intervention. CONCLUSIONS: Psychosexual concerns arise from internal and external influences that significantly affect the decision to undergo prophylactic measures. Therefore, body image, sexuality, and sexual orientation should all be addressed during the decision-making process. IMPLICATIONS: Provider communication and preparation for realistic surgical outcomes can be improved to assist WCBA throughout the decision-making process and enhance psychosexual functioning.