"Some worry about cancer recurrence is understandable. But for some women, these worries can be so strong that they impact their treatment decisions, symptom reporting and screening behaviors, and overall quality of life," says study author Nancy K Janz,  professor of health behavior and health education at the U-M School of Public Health.

The researchers found substantial variation based on racial or ethnic background, with Latinas who speak primarily Spanish expressing the most worry and African-Americans expressing the least worry. For Latinas, the researchers considered acculturation, a measure of how much a person is integrated into American society. For Latinas, a significant factor is whether they speak primarily English or Spanish.

While 46 percent of Latinas who spoke primarily Spanish reported they worry "very much" about recurrence, that number drops to 25 percent for Latinas who speak primarily English, 14 percent for white women and 13 percent for African-Americans.

On the other hand, about 29 percent of African-American women said they were not at all worried about recurrence, while only 10 percent of Latinas who spoke little English did.

Researchers from the Cancer Surveillance and Outcomes Research Team, a multidisciplinary collaboration among five centers across the country, surveyed 1,837 women in Detroit and Los Angeles who had been diagnosed with breast cancer. Results appear in the April one issue of Cancer.

In addition, researchers found that women who reported understanding information better, receiving more help with their symptoms and receiving more coordinated care were less likely to worry about recurrence.

Previous studies suggested women are frequently dissatisfied with the information they receive about their recurrence risk. The current study’s authors highlight the need to provide better counseling about recurrence.

"The challenge is to ensure women are aware of the signs of recurrence while not increasing anxious preoccupation with excessive worry. How much women worry about recurrence is often not aligned with their actual risk for cancer recurrence," Janz says.

"We need to better understand the factors that increase the likelihood women will worry and develop strategies to help women with excessive worry. Programs to assist women must be culturally sensitive and tailored to differences in communication style, social support and coping strategies," she adds.