Racial Perceptions of Communication in Breast Cancer Diagnosis

To evaluate whether race affects how the healthcare team communicates with the patient, from the woman's perspective.

A cross-sectional study used the postoperative module of the BREAST-Q questionnaire to assess patients' perceptions of communication with the healthcare team. The questionnaire was applied to perioperative women after being diagnosed with breast cancer. The final sample consisted of 98 patients. The main outcome was the questionnaire score. Variables included self-reported skin color, professional type, and others. We used proper tests to compare the variables, and linear regressions to test independent variables.

Of the 98 women analyzed, 54 self-identified as White (55.1%) and 44 as Black (44.9%). 58.1% of Black women responded that if they had a different skin color, their treatment would have differed, compared with 29.6% of the White women (p = 0.005). Regarding communication with breast surgeon staff, self-declared race, income, and work location negatively influenced the score. However, communication with nursing staff was only negatively affected by self-declared race and income. Moreover, only self-declared race influenced communication with support staff. In the multiple regression analyses, self-declared race was the only factor that, in isolation, negatively influenced communication between woman and staff. Satisfaction scores were most similar when communicating with the support team and least similar when relating to the breast surgeon.

Self-reported race was the main factor associated with perceived poorer patient-staff communication during the diagnosis and initial treatment of breast cancer. Structural inequalities in communication should be addressed.