Knowledge of diagnosis characteristics and treatment received among Mexican breast cancer survivors.
Authors: Frayde Aguilar Citlali , Mac Donald Jaramillo Maria Andrea , Verduzco-Aguirre Haydee Cristina , Leon-Rodriguez Eucario , Martinez-Cannon Bertha Alejandra 
Published: June 2024

9043

Background: In Mexico, over half a million breast cancer (BC) survivors were estimated in 2020. Limited knowledge among BC survivors about their diagnosis and treatment may negatively impact their adherence to adjuvant therapy and follow-up, and thus, clinical outcomes. This study aimed to evaluate BC survivors’ knowledge of their diagnosis and treatment in a Mexican BC referral center. Methods: A cross-sectional, 36-item survey evaluating knowledge of their diagnosis and treatment was conducted among BC survivors in a referral center in Mexico City. Women diagnosed with stage I-III BC who had completed chemotherapy and radiotherapy were invited to participate between October 2023 and January 2024. Knowledge was estimated by comparing survivors’ responses to medical records. Descriptive statistics were used to analyze participants’ characteristics, knowledge, and information-seeking behaviors. Chi-square test was used to evaluate associations. Results: Among 129 eligible women, 95 (74%) answered the survey. At the time of the survey, mean age was 59 years, 53% had at least high school education, and 46% were unpartnered. Mean time from diagnosis to survey was 4.8 years (SD ± 2.84). Clinical stage at diagnosis was I (34%), II (41%), and III (25%). All patients underwent surgery, 76% radiotherapy, 67% chemotherapy, 88% endocrine therapy, and 14% HER-2 targeted therapy. Reporting was most frequently correct for radiotherapy (99%), tumor laterality (97%), HER2-targeted therapy (93%), and type of breast surgery (91%). Correct reporting for lymph node status was 78%, endocrine therapy 73%, clinical stage 50%, axillary surgery 44%, chemotherapy 43%, estrogen receptor 34%, histologic subtype 25%, HER2 status 24%, progesterone receptor 16%, and histologic grade 16%. BC survivors ≤60 years (p=0.005) and with at least high school education (p=0.039) were more likely to correctly report histologic subtype. Those unpartnered (p=0.013) and those ≤5 years since diagnosis (p=0.017) were more likely to correctly report chemotherapy regimen. Forty-one (43%) survivors reported seeking additional information, mean number of sources was 1.3 (SD ± 1.96), and the most frequent source was internet (39%). Patients whose with ≥1 information source were more likely to correctly report histologic subtype (p<0.001), clinical stage (p=0.005), and receptor status (p=0.019). No associations were found between correct reporting of treatment, sociodemographic variables, and information-seeking behaviors. Conclusions: Most of the surveyed BC survivors had less knowledge of their diagnosis than their treatment. Although age, marital status, education level, and information-seeking behaviors were associated with higher diagnosis knowledge, no associations were found for treatment. Culturally appropriate strategies to improve knowledge among BC survivors are needed to empower this growing population.