Applying the Intersectionality Lens to Understand Minority Ethnic Women's Experiences of the Breast Cancer Care Pathway in England: A Qualitative Interview Study.

Abstract

Background: Exploring the role of structural power in relation to an individual's location in society can yield novel insights into cancer inequities. We aimed to understand how minority ethnic women's identities (age, gender, ethnicity, social position) intersected with social networks and healthcare services to influence their experiences of breast cancer care.

Methods: Semi-structured interviews with 20 women aged 31-60 years with a breast cancer diagnosis identifying as: Asian (n = 7), Black (n = 9), and of mixed ethnicity (n = 4) about their breast cancer journey. Data were analysed using Framework Analysis.

Results: We developed four themes; feeling stereotyped by (a) healthcare professionals (HCPs) and (b) social networks; influence of HCPs' knowledge, attitudes, and behaviours; perceived barriers in healthcare services; and influence of cultural beliefs. We provided a visual representation to illustrate the multifaceted factors that explain pathways to breast cancer inequities for these groups.

Conclusion: Our findings underscored that minority ethnic women negotiated complex processes that influence their coping responses, access to services, and management of their disease. Our study exposed institutional deficiencies that systematically disadvantage minority ethnic women. These findings suggest that policymakers and clinicians should reformulate policies and cancer services to ensure all women with breast cancer receive equal and optimal care.