Racial/Ethnic Differences in Breast Cancer Outcomes Among Older Patients: Effects of Physician Communication and Patient Empowerment

Objectives: To examine racial/ethnic disparities in older women's health-related quality of life (QoL) and type of breast cancer treatment as mediated by physician-level and individual-level variables. Methods: A cross-sectional survey of a population-based, consecutive sample identified through the Los Angeles Cancer Surveillance Program of Latina (n = 99), African American (It = 66). and White (n = 92) women aged 55 years or older (N = 257) between 3 and 9 months after primary breast cancer diagnosis and at least I month posttreatment. An exploratory, empirically developed latent variable model tested the relationships among demographic and physician-related variables, patient attitudes, and health-related Outcomes. Health-related Outcomes included QoL measures and receipt of breast conserving Surgery (BCS). Results: Latinas reported less BCS and poorer QoL compared with Whites. Physician communication that can empower patients, in terms of patient efficacy in patient-physician interactions and breast cancer knowledge. mitigated racial/ethnic disparities in receipt of BCS. Physician emotional support was not related to patient cognitive empowerment and treatment Outcomes. Medical mistrust in minority women was related to less self-efficacy and less positive coping. as well as, both directly and indirectly. to reduced QoL. Latinas reported poorer QoL in the tested model. Conclusion: Physician communication style. specifically information giving and participatory decision making, may empower,ate racial/ethnic disparities in surgical treatment received. older women with breast cancer and help mitigate racial/ethnic disparities in surgical treatment received.