Case 2
Submitted by Maribel Serrano, M.D.

E.V. is a 46 year old Latina who has been living at a migrant labor camp for the past 2 years.  E.V.’s mother recently passed away from breast cancer that was diagnosed at a late stage.  Her mother never sought medical care because she did not have insurance or any other financial means to pay for medical services.  She never received a clinical breast exam or a mammogram. In fact, her mother told her that she had never even had a pap smear. 

E.V. still mourning the loss of her mother, has the fear that she too will follow the fate of her mother.  She has two children and her husband’s work is their only source of income.  When her children get ill, she takes them to the community health clinic in town to be seen. She has never received preventive health care services for herself because of the lack of money.  She has never received a mammogram and with the death of her mother, she states that she does not want to know if she has signs of breast cancer. 

What are some of the most important factors in this case that may impact your approach to this patient and the care that she requires? What strategies would you use to approach her? Proceed to the next section to learn more about cervical and breast cancer in Hispanic/Latina women.....