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Derrick
14-11-05, 09:52
Ethnic minorities less breast aware



By Jane Elliott
BBC News health reporter

Pushpa knew nothing about breast cancer
When Emel Murat discovered a lump in her breast she did not go to her doctor for nine months.

Emel, an ethnic Turkish-Cypriot living in Britain, said she had known little about breast cancer, as it is a taboo subject in her community, and had not known how dangerous her lump was.

When she finally had the lump investigated, her cancer was very advanced and her tumour so large that it was protruding from her breast.

She needed the lump removed and had 16 weeks chemo-therapy and six weeks of radiotherapy.

Now, nearly five years later, she is in remission and is hoping to get the all-clear.

But she knows that, had she waited much longer, her outcome could have been very bleak.


Cancer is a taboo subject in my community. It is just not discussed, I think it is the fear factor
Emel Murat

"I was not aware that the lump could be sinister.

"I thought if it had been anything to worry about that I would have been unwell, but I was fit and healthy and looking after my family.

"I just kept thinking that when I had a quiet moment I would do something about it. But had I left it much longer I don't know what the consequences would have been."


A recent study by the charity Breast Cancer Care confirms that women from black and ethnic minority communities, like Emel, are much less likely to check their breasts for unusual changes than white British women.

The study of 1,633 women from across the UK, found that 43% of ethnic minority women said they had never checked their breasts compared to just 11% of the general population.

A third of the women from ethnic minorities questioned also admitted they did not know much about the disease. And 45% of the over-50s said they had never been to a breast-screening appointment.

Of those who did not attend a screening 76% said it was because they had not been invited.

Emel, 52, from Cheshunt, Hertfordshire, said the findings did not surprise her. She blamed in part cultural differences for the lack of awareness.

"I had not come across breast cancer until I was diagnosed, as cancer is a taboo subject in my community. It is just not discussed, I think it is the fear factor.


We need help in explaining to our mothers and grandmothers what screening is and what they can expect
Pushpa Martin

"It was only after I had breast cancer that I discovered that my mother's sister had cervical cancer."

She said literature needed to be made more user friendly for women from ethnic groups.

Pushpa Martin, 41, from Harrow, Middlesex, is of Asian origin.

She was first diagnosed with cancer five years ago and is in remission, but she says she knew nothing about the disease before she got it.

"I was not aware of it at all, even when I found a lump in my breast.

"Originally I was not going to go to the doctor, but my colleagues at work said I should, so I did."

She said that now she always advised women to examine their breasts and to educate the older generations in their own communities.

"My mum for example didn't even know what a mammogram was. We need help in explaining to our mothers and grandmothers what screening is and what they can expect.

"It is also important for doctors and nurses to be trained in supporting those who are wary of examining their breasts."

Information

Professor Kefah Mokbel , consultant breast and endocrine surgeon at St Georges Hospital said his clinical practice supported the findings and called for better resources to target the ethnic minorities.

"There is a lack of information in all languages and a lack of information that is culturally sensitive."

He said he would like to see GPs, who have a rapport with their patients, calling them for screening, rather a reliance on the impersonal national programme.

And he said specialists, like himself, must take the time to explain all the options to women with breast cancer.

"There is no doubt that the ethnic minorities tend to present with the more advanced sort of breast cancers.

"There is also a rise among the number of young women presenting and they tend to have the more aggressive cancer.

"Those who do present are more likely to undergo a mastectomy than the rest of the population, partly due to the fact that they do not realise that they have other choices.

"They are also less likely to have reconstructions afterwards."

Professor Mokbel said while he welcomed the Breast Cancer Care report he wanted to see more detailed research to confirm his own anecdotal findings.


Anna Wood, policy and campaigns manager for Breast Cancer Care, said their study showed the importance of focusing on minority groups.

"We think that it is important we get the message across. It really needs to be better targeted."

Julietta Patnick, Director, NHS Cancer Screening Programmes said it is committed to ensuring the service is accessible to all.

"The programme works with charities, medical experts and women to produce a range of materials enabling women from different cultural groups to understand their screening invitation and the benefits and limitations of the test.

"A leaflet explaining breast screening is sent out to every woman invited for breast screening and is available in 18 different languages.

"The programme routinely works with screening units and other agencies to support and encourage initiatives targeting specific ethnic groups.

"One current initiative is the development of videos and DVDs which help to explain breast screening to women from the Chinese and South Asian communities."