




































Special Edition: Junior Clinical Research (2023), Vol. 3 No. S2 
 https://doi.org/10.47488/dhrp.v3iS2.83 

 

 
 

 
DHR Proceedings ǀ http://dhrproceedings.org 19 2023, Vol. 2 No. S2 19-23 

 

COMMENTARY 

How Breast Cancer Treatments Affect 

Hispanic Psychologically Post-Treatment 
 

Samantha N. Espinoza1,2, Elise Hernandez1,3, Fernando Saucedo Jr.1,3, Estevan Bonilla1,3, Natasha 

Perez1,4, Julian Gonzalez Jr.1,4, Abigail Herrera1,2, Savannah N. Puente1,2, Faith L. Perez1,4, Iliana 

Rios1,4 

 
1 3rdAnnual Junior Clinical Research Internship, South Texas Academy for Education & Training in Research, DHR Health  

   Institute for Research and Development 
2 Weslaco High School, TX 
3 Harlingen High School, TX 
4 Santa Rosa High School, TX 

 

Received: June 16, 2023  

Accepted for publication: October 25, 2023 

Published: November 16, 2023

 

Introduction 

 
In the United States, breast cancer accounts for nearly 

30% of all new cancer cases each year.1 It is the 

primary cause of cancer death among Hispanic women 

and the second highest cause of cancer death among 

all females.2 According to the Breast Cancer Research 

Foundation, Hispanic women are more likely to 

experience an earlier onset of an aggressive illness 

such as triple-negative breast cancer.3 In the United 

States, every year, about 264,000 women are 

diagnosed with breast cancer. Among these women, 

around 39% reported non-specific distress, 34% 

experienced anxiety, 31% reported symptoms of post-

traumatic stress, and 20% experienced depression 

following their diagnosis.4 Awareness of a cancer 

diagnosis can cause severe emotional distress, creating 

a psychological imbalance among patients, 

subsequently affecting their quality of life. Following 

a patient’s diagnosis, there are many factors that 

contribute to adverse psychological effects related to 

therapies and treatment such as chemotherapy, 

hormonal therapy, medical menopause, and 

hypothyroidism.5 In addition to this, therapies 

themselves can cause patients to experience common 

side effects such as fatigue, nausea/vomiting, diarrhea, 

constipation, pain, arm swelling, shortness of breath, 

and skin irritation.6 In addition to the conflicting 

symptoms and effects one may experience during 

surgery, an entire new set of complications derive  

 

from previous treatments, further advancing one's 

psychological state. Surgeries such as lumpectomies 

and mastectomies can also affect the quality of life of 

patients as it alters their body, leading to loss of self-

confidence. The physical side effects of breast cancer 

treatment can include altered body shape, hair loss, 

early menopause, and infertility.7 The breast is one of 

the most common symbols of femininity. Thus, the 

surgical removal of one or both breasts can cause 

harmful psychological effects on a woman. A woman 

who has lost a breast may feel self-conscious, 

insecure, submissive to other women, and less 

attractive, especially in the eyes of their partner.8 

Moreover, the cost to cover respective treatments, 

surgeries, medications, and doctor visits can be 

expensive, especially if a patient does not have 

medical insurance. Even if one does have insurance, 

certain treatments not covered by insurance and other 

out-of-pocket costs can result in significant debt, even 

after treatment has ended. Depending on the severity 

of their cancer and their health status, patients may not 

be able to work as much or at all.9 The loss of income 

can cause significant financial and familial strain, 

further demonstrating the persisting impacts of breast 

cancer on patients. 

 

 

 

 



Special Edition: Junior Clinical Research (2023), Vol. 3 No. S2 
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DHR Proceedings ǀ http://dhrproceedings.org 20 2023, Vol. 2 No. S2 19-23 

Hispanic Women Compared to Other 

Ethnicities 
 

Hispanic women, compared to other 

ethnicities, are at higher risk of going undiagnosed for 

breast cancer for longer periods of time.10 They are 

30% less likely to be diagnosed for the fact that most 

of them are not exposed to breast cancer screenings or 

are not aware of its symptoms.3 One of the most 

effective ways of achieving early identification of 

breast cancer in women is through routine 

mammogram screenings. Amongst underserved 

communities, screenings and informational 

advertisements about breast cancer may not be 

promoted by any of their healthcare facilities or public 

health groups. Providing breast cancer education and 

adopting risk education measures, in culturally 

sensitive and dual language situations, could 

potentially keep incidence and death by cancer low. 

Within ethnic and racial populations in the United 

States, differences in the incidence rate, survival rate, 

and features of the tumor are seen. Epidemiologic 

studies that mostly included non-Hispanic White 

women have discovered risks for breast cancer, which 

limits an understanding of how important these factors 

are to different ethnic groups.11 Despite Hispanics 

being around 15% of the population in the United 

States, which is still currently expanding, only very 

few studies have examined the thorough effects of 

breast cancer risk factors in these populations. Less 

than 3% of individuals involved in clinical trials are 

Black, 12.7% of Americans have African or Caribbean 

heritage. In contrast, compared to the prevalence of 

cancer, Asian communities are typically 

overrepresented in cancer therapeutic trials.11 Clinical 

research does not have enough diverse patient 

populations. It mainly includes non-Hispanic White 

populations, which restricts our understanding of 

significant biological and social distinctions that may 

influence the development of treatments. 

 

Body Image 
 

“I look in a mirror and the result is deformity. Nothing, 

but just deformity,” a quote stated by one of many 

breast cancer survivors.12 Society today tends to 

portray what the perfect female body should look like. 

Body image is the depiction of one’s own body in their 

own mind. Breast cancer survivors suffer with self-

confidence and body image due to the fact that they 

undergo many different treatments that can physically 

alter their appearance, such as chemotherapy. 

Chemotherapy is the practical use of powerful 

chemicals that are inserted through the bloodstream 

intravenously (IV).13 This treatment destroys both 

tumor and healthy cells and can result in hair loss. This 

feminine feature is very significant to women as it 

plays a part in defining their identity as a woman.8 

Mastectomies which are the surgical removal of one or 

both breasts is another treatment that physically alters 

the appearance of a woman’s body. Over 100,000 

women receive mastectomies annually.14and therefore 

a large portion of the US female population is affected. 

A study conducted by  Remmers, et.al., surveyed 

volunteers who participated in a report about the after-

thought of themselves being frightened and startled 

when they first saw the surgical site.15 This can trigger 

many emotions such as depression, anxiety, and a lack 

of self-confidence. Because of this, having this form 

of cancer can leave a heavy toll on the mental and 

physical state of the human body. 

 

Mental Disorders and other Psychological 

Factors 

 
Depression, anxiety, decrease in self-

confidence are some of many psychological effects 

that breast cancer survivors experience during and 

after their treatments.17 However, in Hispanic 

households, acknowledgement of mental health issues 

are either entirely avoided or perceived as non-existent 

or abnormal.18 Therefore, when they are diagnosed 

with breast cancer, the psychological effects that come 

from the diagnosis are generally disregarded since 

they don’t get the proper information on mental health 

and that way they won’t be seen as unstable.18 We will 

go into deeper discussion on how these psychological 

disorders affect the Hispanics women with the 

discussion on the two most impacting disorders: 

depression and anxiety. Depression or major 

depressive disorder is a mental illness that affects not 

only your psychological well-being but your physical 

well-being too.19 It can affect their mental stability 

which in turn has them not only isolate themselves 

from others, but also make a simple task seem 

impossible. For instance, just getting up to shower, 

brushing their teeth, and keeping up with their hygiene 

can be hard for someone who is suffering from this 

condition.20 Others who have not gone through this 

experience themselves may be quick to judge and 

think “it’s such a simple task, they're just being lazy” 

when they don’t even know what it actually feels like 

to battle yourself within your mind. The fuel that is 

added to one's depression is also having low self-

esteem. Especially since most breast cancer survivors 

result in getting a mastectomy as previously 

mentioned. The scarring that comes from the surgical 

procedure may worsen their isolation from society. 

One quote that shows this is from a participant from a 

study on how body image is perceived in women after 



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DHR Proceedings ǀ http://dhrproceedings.org 21 2023, Vol. 2 No. S2 19-23 

their mastectomies. The quote states “I didn’t want to 

see the operation area at all; I saw it when I was back 

home. Before seeing it, I knew that I was going to feel 

the emptiness but when I saw it, I felt very different 

(crying), words are never enough to explain”.16 

Therefore, insecurity and lack of self-confidence will 

hold them back from living life and being who they 

were before the cancer. Anxiety is another mental 

health illness that can affect many women with breast 

cancer. In a recent study, 32% of breast cancer patients 

experienced symptoms of anxiety.21 Having anxiety 

impacts these women's lives. Anxiety is an emotional 

disorder which happens because of stress but when it's 

a disorder it gets worse and doesn't go away.22 For 

breast cancer survivors it is fearing recurrence, 

hopelessness, fearing for the worst and uncertainty of 

the future. Anxiety may affect a patient’s ability to 

complete daily tasks of everyday life. It can creep up 

all of a sudden with panic and may go away at any 

given time. It can affect a person's life by getting in the 

way of family and friends, job performance, and social 

skills. Self-confidence is also greatly affected by 

breast cancer diagnosis and may stop the patient's 

ability to be around people.  Patient’s may get 

overwhelmed by going out so they usually avoid 

interacting with others.  However, anxiety affects your 

mental and physical health. Some of the physical 

effects are being restless, nauseous, light headed or 

dizzy, and stomachaches.23 You can also get panic 

attacks when someone or something reminds you of 

those hard times. People who have experienced 

anxiety before know the symptoms and how it feels, 

but those patients who have never experienced anxiety 

aren't prepared for it.  

 

Disturbance in Social Life  
 

The way of life, beliefs, and values that are 

passed down from one generation to the next, also 

known as culture, can impact how people view and 

manage their health and well-being, as well as their 

perception of the world in a situation where something 

seems unmanageable, like being diagnosed with breast 

cancer. Along with mental health issues among breast 

cancer survivors, specifically Hispanic women, there 

are a variety of social repercussions that affect their 

quality of life. In a 2011 survey, researchers from 

Georgetown University found reoccurring themes 

present throughout the lives of Hispanic women post 

treatment such as shame, religion, and more which 

have impacted their standard of living.24 Their social 

interactions are often limited due to strains on their 

physical health leading to feelings of isolation, 

including a sense of burden. Additionally, they may be 

incapable of performing their assigned familial role 

leading to further sense of isolation.25 Furthermore, 

studies on breast cancer survivors exhibit how 

Hispanic women are especially receptive towards 

stigmas and responses from family members 

concerning their illness and how marianismo, a gender 

role expressing female submissiveness, plays another 

factor to their social life.26 For instance, some women 

may feel cultural pressure to remain an all-nurturing 

figure and even self-sacrificial for the benefit of their 

husbands. This can also create extensive loneliness as 

patients refuse to discuss the disease with their 

spouses. In addition to survivors’ concerns and fears, 

another notable factor that dictates their quality of life 

socially is their religion. As for the survey listed 

above, the majority of Hispanic women put their fears 

and concerns aside, after their diagnosis, in order to 

find consolation in God.24 However, that isn’t always 

the case for all patients. Others have reported their 

diagnosis and post-treatment complications were a 

punishment from God, which led them to question 

their commitment, because most of these patients 

depended on religious support to determine the bulk of 

their well-being.27 For instance, solidarity from 

religion has been linked to higher quality of life for 

patients suffering with cancer.27 Qualitative studies on 

this demographic, Hispanic women, propose that 

cultural components demonstrate a distinct 

vulnerability throughout their experience of breast 

cancer from diagnosis, treatment, and to remission. 

 

Conclusion 
 

Current evidence supports the fact that 

Hispanic women with breast cancer have a difficult 

time processing their diagnosis.  Once being 

diagnosed, there are drastic changes to their bodies, 

body image, mental health, and social life. Once 

therapy begins, patients' perceptions of their bodies 

start to change as a result of losing things such as hair, 

breasts, and self-confidence. Between 40% and 100% 

patients experience hair thinning, 59.3% reduced in 

hair volume and 62.5% of patients' hair didn't come 

back after treatment.28 Mental health issues can have 

an impact on an individual both during and after 

treatment, including insomnia, severe anxiety and 

depression. The rate of breast cancer patients getting 

depression ranges from 1.5-50% depending on the 

diagnosis.29 Patients' social lives affect how they 

interact with their family and friends throughout 

therapy, and some even start to doubt their religious 

beliefs and ask God why they were diagnosed. Pooled 

data from studies showed that 45% reported high 

levels of social difficulty.30 Therefore, having more 

awareness and understanding of said issues can 

tremendously aid the patient's recovery.  



Special Edition: Junior Clinical Research (2023), Vol. 3 No. S2 
 https://doi.org/10.47488/dhrp.v3iS2.83 

 

 
 

 
DHR Proceedings ǀ http://dhrproceedings.org 22 2023, Vol. 2 No. S2 19-23 

Resources that Hispanic women can use to 

cope with their diagnosis are Susan G. Komen, 

HERConnection, 24/7 Cancer helpline, Mary Ann 

Liebrt, and Patient-Centered Outcomes Research 

Institute.  

 

Acknowledgements 

Monica Betancourt-Garcia, MD, Program Director; 

Melissa Eddy, MS, Program Manager  

Funding 

Funded by DHR Health Institute for Research & 

Development; DHR Health; Region One ESC 

GEARUP College Ready, Career Set!; Region One 

ESC GEARUP College Now, Career Connected; 

Region One ESC PATHS; Region One ESC Upward 

Bound Math & Science; Benavides ISD; and Jubilee 

Academy-Brownsville  

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