Experiences of Korean-American Women with High Risk Hereditary Breast Cancer

고위험 유전성 유방암을 지닌 한국계 미국 여성의 질병경험

  • Choi, Kyung-Sook (Department of Nursing, Chung-Ang University) ;
  • Jun, Myung-Hee (Department of Nursing, Daejeon University & University of Wisconsin-Milwaukee) ;
  • Anderson, Gwen (School of Nursing, San Diego State University & VA San Diego Healthcare System)
  • 최경숙 (중앙대학교 간호학과) ;
  • 전명희 (대전대학교 간호학과 & 위스콘신-밀워키 주립대학교 간호학과) ;
  • Received : 2012.05.08
  • Accepted : 2012.06.02
  • Published : 2012.06.30


Purpose: This micro-ethnographic study aimed to understand coping experiences of Korean-American (K-A) women after diagnosis with breast cancer due to a hereditary gene mutation. Methods: Participatory observation and in-depth interviews were performed at one breast cancer screening center in Southern California, in 2005 with eleven first generation K-A immigrant women. All transcribed interviews and field notes were analyzed using ethnographic methodology. Results: K-A women's experience varied based on acculturation risk factors including: limited English speaking ability; disrupted family relationships, individualistic family values, or intergenerational communication barriers; lack of Korean speaking nurses; and Korean physicians' who lacked knowledge about hereditary breast cancer risk. These risk factors led to isolation, loneliness, lack of emotional and social support. In comparison to Korean homeland women in a similar medical situation, these K-A immigrants felt disconnected from the healthcare system, family support and social resources which increased their struggling and impeded coping during their survivorship journey. These women were not able to access self-support groups, nor the valuable resources of nurse navigator programs. Conclusion: Professional oncology associations for nurses and physicians have a moral obligation to support and promote knowledge of hereditary cancer risk and self-help groups for non-native speaking immigrants.


Supported by : 한국연구재단


  1. Han SA, Park SK, Ahn SH, Lee MH, Noh DY, Kim LS, et al. The Korean Hereditary Breast Cancer (KOHBRA) study: protocols and interim report. Clin Oncol (R CollRadiol) 2011;23:434-41.
  2. Jun M, Choi K, Ahn S, Gu B. Experiences of breast cancer women undertaking genetic tests. J Korean Oncol Nurs 2005;5:79-91.
  3. Choi KS, Jun MH, Ahn SH, Anderson G. Implementing and evaluating a nurse led hereditary cancer genetics educational program in a Korean breast cancer surgery clinic. J Korean Acad Adult Nurs 2008;20:815-28.
  4. Choi KS, Jun MH, Anderson G. The first Korean cancer genetic counseling program for nurses. J Korean Acad Soc Nurs Educ 2006;12:104-14.
  5. Choi KS, Jang ES, Jun MH, Jung JY, Park JA. The effect of the cancer genetic education program for nurses. J Korean Oncol Nurs 2010;10:240-6.
  6. WHO. GLOBOCAN 2008 (IARC) Section of cancer. Available at: http: //[accessed on 7 June 2012].
  7. Curado MP, Edwards B, Shin HR, Storm H, Ferlay J, Heanue M, et al. Cancer Incidence in five continents, Vol. IX. Lyon:IARC Scientific Publishers;2009.
  8. Yoo K, Kang D, Park S, Kim S, Shin A, Yoon H, et al. Epidemiology of breast cancer in Korea: occurrence, hight risk groups and prevention. J Korean Med Sci 2001;17:1-6.
  9. Anderson G, Jun M, Choi KS. Breast cancer screening for Korean women must consider traditional risks as well as two genetic risk factors: genetic polymorphisms and inheritable gene mutations. Cancer Nurs 2007;30: 1-10.
  10. Gomez SL, Quach T, Horn-Ross PL, Pham JT, Cockburn M, Chang ET, et al. Hidden breast cancer disparities in Asian women: disaggregating incidence rates by ethnicity and migrant status. Am J Public Health 2010; 100Suppl 1:S125-31.
  11. Gomez SL, Clarke CA, Shema SJ, Chang ET, Keegan TH, Glaser SL. Disparities in breast cancer survival among Asian women by ethnicity and immigrant status: a population-based study. Am J Public Health 2010; 100:861-9.
  12. Cheon L. History of Korean immigration. J His Cul Geo 2002;14:109-22.
  13. Min PG. Koreans' immigration to the U.S: History and contemporary trends. New York:The Research center for Korean community Queens college of CUNY;2011.
  14. Ministry of Foreign Affair and Trade. Immigration statistics. 2011. http: // jsp?typeID=6&boardid=232&seqno=334627 [accessed on 1 June 2012].
  15. Choi KS, Lee S, Park EC, Kwak MS, Spring BJ, Juon HS. Comparison of breast cancer screening rates between Korean women in America versus korea. J Womens Health 2010;19:1089-96.
  16. Lee H, Kim J, Han HR. Do cultural factors predict mammography behavior among Korean immigrants in the USA? JAN 2009;65:2574-84.
  17. Ma GX, Shive S, Toubbel J, Tan Y, Wang MQ. Factors associated with mammography compliance and non-compliance among Chinese, Korean, Vietnamese and Cambodian women. Am J Health Stud 2007;22: 233-43.
  18. Maxwell A, Jo A, Crespi C, Sudan M, Bastani R. Peer navigation improves diagnostic follow-up after breast cancer screening among Korean American women: Results of a randomized trial. Cancer Causes & Control 2010;21:1931-40.
  19. Maxwell AE, Jo A, Chin SY, Lee KS, Bastani R. Impact of a print intervention to increase annual mammography screening among Korean American women enrolled in the national breast and cervical cancer early detection program. Cancer Detect Prev 2008;32:229-35.
  20. Juon HS, Choi S, Klassen A, Roter, D. Impact of breast cancer screening intervention on Korean-American women in maryland. Cancer Detect Prev 2006;30:297-305.
  21. Agar MH. The professional stranger. Orland City:Academic Publishers;1980.
  22. Kwok C, White K. Cultural and linguistic isolation: The breast cancer experience of Chinese-Australian women - A qualitative study. Contemp Nurse 2011;39:85-94.
  23. Asti T, Kara M, Ipek G, Erci B. The experiences of loneliness, depression and social support of Turkish patients with continuous ambulatory peritoneal dialysis and their caregivers. J Clin Nurs 2006;15:490-7.
  24. Yildirim Y, Kocabiyik S. The relationship between social support and loneliness in Turkish patients with cancer. J Clin Nurs 2010;19:832-9.
  25. Friedman G, Florian V, Zernitsky-Shurka E. The experience of loneliness among young adult cancer patients. J Psychosoc Oncol 1989;7:1-15.
  26. Sekse RJ, Raaheim M, Blaaka G, Gjendal E. Life beyond cancer: women's experiences 5 years after treatment for gynaecological cancer. Scand J Caring Sci 2010;24:799-807.
  27. Choi SK. The centennial of Korean immigration to the U.S.: Evaluation and prospects. Soc Sci Res 2011;12:151-68.
  28. Alexandra VG, Mechthild N, Siegfried G. Differences in illness-related knowledge of breast cancer patients according to their involvement in self-help groups. J Psychosom Obstet Gynaecol 2011;32:147-53.
  29. Yamazaki Y, Nakayama K. Comparing support to breast cancer patients from online communities and face-to-face support groups. Patient Educ Couns 2011;85:e95-e100.