Latin American Women Research Articles

Abstract B79: Breast cancer characteristics and survival among Indigenous American women from Peru

Abstract Background: Breast cancer prognosis depends on stage at diagnosis and varies by intrinsic tumor subtype. In the US, the distribution of intrinsic subtypes has been shown to differ between racial/ethnic groups with African American and Hispanic/Latina women more likely to be diagnosed with the more aggressive triple-negative breast cancer (TNBC) lacking expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2), compared to non-Hispanic/Latino White women. Hispanics/Latinos in the US are a heterogeneous group originating from different countries with different cultures and ancestral backgrounds. Information about the distribution of tumor subtypes in Latin American regions is lacking. Methods: Data for these analyses come from the Instituto Nacional de Enfermedades Neoplásicas (the Peruvian National Cancer Institute), which diagnoses and treats ~20% of all breast cancers diagnosed in Peru. We have abstracted data from clinical records for 303 patients diagnosed with breast cancer between 2010 and 2015 and who are members of Indigenous American communities from the Andean Mountain region (N=232) or the Amazonian region (N=71). We compared tumor characteristics and survival between the two groups. Comparisons between the two regions were conducted using chi-squared tests, as well as a t-test for age at diagnosis. Breast cancer subtype was defined as luminal A (ER/PR+/HER2-), luminal B (ER+/HER2+), HER2 overexpressing (ER/PR- HER2+), and triple-negative (ER/PR- HER2-) based on immunohistochemistry. Survival analyses were conducted using a Cox proportional hazards model and included region, age at diagnosis, stage, and tumor subtype as predictors. Results: Overall, tumors from the 303 Indigenous American women from Peru included in the present study were 37% luminal A, 20% luminal B, 23% HER2 overexpressing, and 19% triple-negative. Our analyses showed that women from the Amazonian region were diagnosed at a younger age (50 vs. 55 mean age at diagnosis, P value =0.001), later stage (61% vs. 48% stage III or IV, P value=0.06), and more frequently with triple-negative tumors compared to women from the Mountain region (31% vs. 17%, P value =0.013). Women from the Amazonian region had a 70% higher mortality hazard than the women from the Mountain region in a model adjusted by age at diagnosis (hazard ratio 1.73, 95%CI 1.06-2.86, p=0.027). In the full model including stage and tumor subtype, the difference in the mortality hazard was no longer statistically significant (HR 1.20, 95%CI 0.71-2.03, p=0.493). Conclusion: Differences in tumor characteristics and survival between Indigenous American women from the Amazonian and Mountain Range regions in Peru could be due to variation in genetic predisposition to particular subtypes of the disease, variation in environmental exposures, as well as to differences in cancer awareness and access to care between the different groups. The more we learn by analyzing diverse populations and subpopulations and revealing heterogeneity within Latin American women, the better equipped we will be to provide adequate care for all women. Citation Format: Lizeth I. Tamayo, Tatiana Vidaurre, Jeannie Navarro Vasquez, Sandro Casavilca, Jessica Ivonne Aramburu Palomino, Monica Calderon, Garth H. Rauscher, Laura Fejerman. Breast cancer characteristics and survival among Indigenous American women from Peru [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr B79.

Anthropometry and risk of breast cancer among premenopausal women in Latin America: Results from the PRECAMA study

Introduction Premenopausal breast cancer risk has been associated with greater height and inversely associated with excess adiposity in many studies conducted among Western populations. However, data are scarce on Hispanic populations, in particular in Latin American countries. Our work investigated the associations between excess adiposity, defined by several anthropometric factors, and risk of breast cancer among premenopausal Latin American women from the PRECAMA study. Methods PRECAMA is an on-going multicentric population-based case-control study conducted in young, premenopausal women from four Latin American countries: Chile, Colombia, Costa Rica, and Mexico. Women aged 20 to 44 years are recruited in the study. Cases are women diagnosed with first primary invasive breast cancer and are recruited before any treatment. Population-based controls are matched to cases on age, area of residence and health institution. Anthropometric measurements were performed by medical staff at inclusion according to standardized protocols, and lifestyle data were collected. Height, weight, BMI, waist and hip circumferences, and their ratios were categorized into tertiles and analyzed using multivariate conditional logistic regression models adjusted for potential confounders. Results Preliminary analyses on 283 cases and matched controls showed no difference in height (average of 1.58 m in cases vs. 1.57 m in controls). Average BMI was 26.9 kg/m2 in cases and 29.1 kg/m2 in controls. Twenty percent of the cases and 29% of the controls were classified as obese (BMI ≥ 30 kg/m2). Adjusted odds ratios (OR) showed a linear inverse association between BMI and breast cancer risk [OR T2 vs. T1 = 0.65; 95% confidence interval (CI) = 0.39–1.09; OR T3 vs. T1 = 0.38; 95% CI = 0.21–0.68; P-trend Conclusions In this population of Latin American women, BMI was the only anthropometric factor associated with risk of premenopausal breast cancer, and no association was observed with height. There results suggest that risk factors for breast cancer may differ from those in other populations.

Translating the Poetry of Graciela Huinao: Finding the Authentic Voice Within

This article discusses the translation of literary works by contemporary Latin American women, specifically the poetry of Graciela Huinao, a Mapuche-Willichewriter from Southern Chile.Given the opportunities for travel and the development of technology such as the Internet, translators today have many ways to interact with writers in order to delve deeper into the translation of their texts. In this context, elements such as hybridity, heteroglossia, paradox, grammatical structures, cultural nuances, and the author’s intention can be explored in greater detail. The translation of Graciela Huinao’s poetry by the author of this article is used to share examples of the exploration of literary and conceptual elements through the use of extensive communications enabled by technology. And in the case of Graciela Huinao’s writing, the relevance and overlapping of Spanish and Mapuzugun, the language of her people, becomes a significant part of the dialogue.

Abstract A38: Identification of triple-negative breast cancer subtypes in Colombian patients

Abstract Background: Studies in Latinas have reported a high prevalence of ER/PR/HER2-negative (TNBC) and HER2-enriched breast tumors. In our ongoing study of breast cancer molecular characteristics of Colombian women (N=301), more than 20% of the tumors were classified as TNBC. Molecular analyses of this aggressive subtype of breast cancer in women of European ancestry have revealed additional molecular heterogeneity, which is associated with treatment response and survival. The goal of the present study was to explore the molecular profile of TNBC in a sample of Latin American women from Colombia and assess if genetic ancestry modified the gene expression profile. Methods: We performed whole-transcriptome RNA-seq analysis in 48 TNBC tumors that were classified into intrinsic subtypes by immunohistochemistry (IHC) following St. Gallen 2015 surrogates. Genetic ancestry was estimated from a panel of 80 ancestry-informative markers (AIM). We categorized patients with TNBC according to the median of Indigenous ancestry (low Indigenous ancestry group: ancestry proportion below the median; high Indigenous ancestry: ancestry proportion above the median). We used top differentially expressed genes from Lehmann et al. (2011) (n=128) to explore the distribution of TNBC subtypes in our samples and to explore differences in the expression of these genes according to genetic ancestry. Results: Unsupervised hierarchical clustering analysis did not show any clear clustering of the Colombian samples into defined subtypes based on expression of the 128 top differentially expressed genes reported by Lehmann et al. Subsequently, we selected genes that clustered together according to the definitions of TNBC subtypes of Lehmann, leaving a total of 35 genes for the analysis. Unsupervised hierarchical clustering using this list of genes identified two clusters, one predominantly observed for woman of high Indigenous American ancestry (average Indigenous American ancestry for this group was 45%) and another more common in women of low Indigenous ancestry (average Indigenous American ancestry for this group was 36%, p=0.04). The cluster that included most of the women with high Indigenous ancestry proportions was characterized by lower gene expression for the 35 genes compared to the cluster that included women with low Indigenous ancestry proportions. Conclusions: Our results suggest differential expression of genes within TNBC breast cancer subtype according to genetic ancestry; nevertheless, we could not identify clear TNBC subtypes previously defined by Lehmann et al. in our study. Further analyses are needed to identify TNBC subtypes in Hispanic/Latina samples. Citation Format: Silvia J. Serrano-Gomez, Maria Carolina Sanabria-Salas, Jone Garai, Melody C. Baddoo, Gustavo Hernandez-Suarez, Juan Carlos Mejia, Oscar Garcia, Lucio Miele, Laura Fejerman, Jovanny Zabaleta. Identification of triple-negative breast cancer subtypes in Colombian patients [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr A38.

Traci Roberts-Camps. 2017. Latin American Women Filmmakers: Social and Cultural Perspectives. Albuquerque: University of New Mexico Press.

Traci Roberts-Camps. 2017. Latin American Women Filmmakers: Social and Cultural Perspectives. Albuquerque: University of New Mexico Press.

Unravelling compulsory happiness in exile: Cristina Peri Rossi’s The Ship of Fools

A number of feminist critics of Latin American women writers in exile have suggested that women in exile may flourish as they are freed from the traditional gender restrictions imposed on them in their home countries. In this article I reexamine the association of exile with liberation through analysing Cristina Peri Rossi’s 1984 novel La nave de los locos ( The Ship of Fools) in the light of the tension between Rosi Braidotti’s Deleuzian affirmation of feminism as a ‘joyful nomadic force’ (1994: 8) and Sara Ahmed’s critique of compulsory happiness (2010). Peri Rossi juxtaposes the prescriptive worldview of the captivating medieval ‘Tapestry of the Creation’ in the Cathedral of Girona in Catalonia, which depicts the Biblical story of Genesis, and the diasporic and unpredictable wanderings of the protagonist Ecks on his journey to feminist enlightenment. I argue that while the novel seems to champion nomadic subjectivity, it also highlights the deceptive charm of imperative positive affect that may function as a disciplinary force, compelling subjects to follow a conventional path in life, and invalidating those who ‘stray’ from it. My reading of the novel calls for a nuanced approach to exile and diaspora that takes into account wider questions of the privilege and ease of movement – or, indeed, settling – enjoyed by or denied to various subjects.

PO-310 Genomic features of premenopausal breast cancers in latin american women: the PRECAMA study

Introduction In Latin America (LA), there is a high incidence rate of breast cancer (BC) in premenopausal women, and the genomic features of these BC remain unknown. Here, we have characterised the molecular features of BC in young LA women within the framework of the PRECAMA study, a multicenter population-based case-control study on breast cancer in premenopausal women. Material and methods Pathological tumour tissues were collected from incident cases from four LA countries. Immunohistochemistry (IHC) was performed centrally for ER, PR, HER2, Ki67, EGFR, CK5/6 and p53 protein markers. Targeted deep sequencing was done on genomic DNA extracted from formalin-fixed paraffin-embedded (FFPE) tumour tissues and their paired blood samples to screen for somatic mutations in eight genes frequently mutated in BC. A subset of samples was analysed by exome sequencing to identify somatic mutational signatures. Results and discussions The majority of cases were positive for ER or PR (168/233; 72%) and 21% of cases were triple negative (TN), mainly of basal type. Most tumours were positive for Ki67 (189/233; 81%). In 126 sequenced cases, TP53 and PIK3CA were the most frequently mutated genes (32.5% and 21.4%, respectively), followed by AKT1 (9.5%). TP53 mutations were more frequent in HER2-enriched and TN IHC subtypes, while PIK3CA/AKT1 mutations were more frequent in ER-positive tumours, as expected. Interestingly, a higher proportion of G:C>T:A mutation type was observed in TP53 gene in PRECAMA cases compared to TCGA and METABRIC breast cancer series (27% vs 14%). Exome-wide mutational patterns in 10 TN cases revealed alterations in signalling transduction pathways and major contributions of mutational signatures caused by altered DNA repair pathways. Conclusion This pilot study on PRECAMA tumours gives a preview of the molecular features of premenopausal BC in LA. Although the overall mutation burden was as expected from data in other populations, mutational patterns observed in TP53 and exome-wide suggested possible differences in mutagenic processes giving rise to these tumours compared to other populations. Further omics analyses of a larger number of cases in the near future will allow investigating relationships between these molecular features and risk factors.

The Stability Paradox: Why Expansion of Women's Education Has Not Delayed Early Union Formation or Childbearing in Latin America.

Despite substantial improvements in women's education, the age at which Latin American women marry (cohabit) or become mothers for the first time has barely decreased over the past four decades. We refer to this as the "stability paradox." We examine the relationship between years of schooling and transitions to first union or child, analyzing retrospective information from 50 cohorts of women born between 1940 and 1989 in 12 Latin American countries. Absolute and relative measures of schooling are compared. Data is drawn from 38 Demographic Health Surveys (DHS) conducted between 1986 and 2012 in these countries. Results show that expected postponement in family transitions due to educational expansion was offset by a rise in union formation and childbearing within strata of absolute education, but stayed approximately constant within strata of relative education. The relative measure of education retains the stratifying power of education but neutralizes any effect attached to a specific number of years of schooling and the learning skills associated with them. This is consistent with the idea that access to education in Latin America reproduces existing patterns of socioeconomic advantage, rather than creating a more equitable distribution of learning opportunities and outcomes.

Epitaph of a Small Winner: My First 50 Years in Academe. An Interview with Judith Ewell

Judith Ewell has been a major figure in modern Latin American history, both as a research scholar and as a teacher. Just before receiving her PhD at the University of New Mexico in 1972, Ewell began teaching at the College of William & Mary in Williamsburg, Virginia, from which she retired in 2004. Ewell's books include The Indictment of a Dictator: The Extradition and Trial of Marcos Pérez Jiménez (1981); Venezuela: A Century of Change (1984); and Venezuela and the United States: From Monroe's Hemisphere to Petroleum's Empire (1996, Spanish ed. 1998). Ewell has also published numerous articles and book chapters on modern Latin American history and women's history. She is co-editor of the much-loved biographical essay collection, The Human Tradition in Latin America (Nineteenth and Twentieth Centuries) with William H. Beezley, with whom she served on the editorial board of Scholarly Resources Press (now Rowman & Littlefield). Most importantly, Ewell served as chief editor of this journal, The Americas, from 1998 to 2003.

Seroprevalence and vertical transmission of Chagas disease in a cohort of Latin-american pregnant women in a tertiary hospital in Madrid

Chagas disease, caused by Trypanosoma cruzi (T. cruzi), is endemic in Latin-America and is emerging in Spain due to immigration. The vertical transmission rate is around 5%. A routine prenatal screening with serology of all pregnant women from endemic areas is recommended to identify infected newborns, allowing early treatment and cure. The aim of this study was to estimate the prevalence of positive Chagas serology in a cohort of pregnant women from Latin-America and its vertical transmission. An observational, prospective, follow-up study was conducted on women with positive serology to T. cruzi, as well as their newborns, from January 2013 to April 2015. Congenital Chagas was ruled out using a PCR technique at birth and at 1 month, and with serology at 9-12 months old. A child was considered infected when PCR was positive, and uninfected when PCR was negative, and/or it had a negative serology. Screening was performed on 1244 pregnant women from Latin-America, and there were positive results in 40 (prevalence 3.2%, 95% CI: 2.4-4.4%), with 85% of them from Bolivia. There was only one infected newborn (rate of vertical transmission 2.8% (95% CI: 0-15%)), who had a positive PCR at birth. Relative studies enabled an 8-year-old sister with an asymptomatic disease to be diagnosed and treated. Both were treated successfully with benznidazole (later the PCR and serology were negative). Screening during pregnancy in Latin-American women helped to detect those with Chagas disease. The rate of vertical transmission was 2.8%, in keeping with literature. Screening led to the detection and treatment of previously unidentified familial cases.

Rewriting History: Colonial Latin American Women in Historical Fiction

Rewriting History: Colonial Latin American Women in Historical Fiction

Female offspring birth weight is associated with Body Mass Index, waist circumference and metabolic syndrome in Latin American women at 10-years postpartum

AimsWe aimed to assess whether female offspring birth weight (BW) is associated with anthropometric and metabolic outcomes in Chilean mothers at 10-years postpartum. MethodsWe assessed data from 396 Chilean mother-daughter pairs participating in the longitudinal Chilean Growth and Obesity Cohort (GOCS) and Determinants of Breast Cancer Risk (DERCAM) studies. Multivariate linear and logistic regression models were performed to associate female offspring BW with maternal Body Mass Index (BMI), waist circumference, type 2 diabetes mellitus, metabolic syndrome and its components at 10-years postpartum. ResultsAt 10-years postpartum, 69% of mothers were overweight, 65% had central adiposity and 26% had metabolic syndrome. Adjusted linear regression models showed associations between female offspring BW and (1) maternal BMI (%Δ GM = 4.46; 95% CI 0.25–8.85); and (2) waist circumference (%Δ GM = 3.25; 95% CI 0–6.60). Adjusted logistic regression models showed associations between female offspring BW and (1) maternal metabolic syndrome (OR = 3.48; 95% CI 1.50–8.11); (2) central adiposity (OR = 2.37; 95% CI 1.08–5.22); and (3) hypertriglyceridemia (OR = 3.19; 95% CI 1.40–7.23). ConclusionsFemale offspring BW was associated with maternal anthropometric and metabolic outcomes at 10-years postpartum. Our findings add to the emerging evidence that offspring BW might be a potential indicator for future maternal anthropometric and metabolic risks.

Maternal conception of gestational weight gain among Latinas: A qualitative study.

Interventions to support healthy gestational weight gain are often ineffective. The objective was to develop a model of how pregnant Latinas-who have a higher risk of poor maternal and neonatal weight-related outcomes-conceptualize healthy gestational weight gain, providing guidance for future interventions. Ten focus groups with 50 pregnant Latinas were conducted by a native Spanish-speaking female moderator. On the basis of participant responses, we used grounded theory to inductively develop a personal conceptual framework for gestational weight gain. Commonly identified barriers to being active and healthy eating included negative emotions, body image, physical discomfort, low energy, and lack of motivation. Women identified sociocultural issues such as a sense of isolation from family (among immigrants) and the degree of perceived social support as important contributors to health behaviors. Two personal health schemas emerged from participant responses. The "mother-child health schema" describes the degree to which participants recognized the interrelatedness of health needs for baby and for themselves. The "attention to gestational weight gain schema" describes how a respondent's attention to and perceived importance of gestational weight gain influences health-related behaviors during pregnancy. Women's sociocultural and interpersonal context influence weight-related behaviors through the lens of personal health schemas. Understanding how cognitive aspects relate to traditional behavioral determinants suggests several opportunities for intervention, such as focusing on healthy behaviors instead of numerical targets for healthy weight gain. Although derived from Spanish-speaking Latin-American women, these results may also be potential leverage points for other minority groups. (PsycINFO Database Record

Gender-Based Administrative Violence as Colonial Strategy

There is a growing trend across North America of women being criminalized for their pregnancy outcomes. Rather than being a series of aberrations resulting from institutional failures, we argue that this trend is part of a colonial strategy of administrative violence aimed at women of color and Native women across Turtle Island. We consider a range of medical and legal practices constituting gender-based administrative violence, and we argue that they are the result of non-accidental and systematic production of population-level harms that cannot be disentangled from the goals of ongoing settler occupation and dispossession of Indigenous lands. While white feminist narratives of gender-based administrative violence in Latin America function to distance the places where such violence occurs from the ‘liberal democratic’ settler nation-states of the U.S. and Canada, we hold that administrative forms of reproductive violence against Latin American women are structurally connected to efforts in the U.S. and Canada to criminalize women of color and Indigenous women for their reproductive outcomes. The purpose of these systemically produced harms is to sustain cultures of gender-based violence in support of settler colonial configurations of power.

Latin American Women and the Literature of Madness: Narratives at the Crossroads of Gender, Politics and the Mind by Elvira Sánchez-Blake and Laura Kanost, and: Intersections of Harm: Narratives of Latina Deviance and Defiance by Laura Halperin

Latin American Women and the Literature of Madness: Narratives at the Crossroads of Gender, Politics and the Mind by Elvira Sánchez-Blake and Laura Kanost, and: Intersections of Harm: Narratives of Latina Deviance and Defiance by Laura Halperin

Roberts-Camps, Traci. Latin American Women Filmmakers: Social and Cultural Perspectives. University of New Mexico Press, 2017. 208pp.

Author(s): Fischer, Carl | Abstract: Roberts-Camps, Traci. Latin American Women Filmmakers: Social and Cultural Perspectives. University of New Mexico Press, 2017. 208pp.

Feminist birds of passage: Feminist and migrant becomings of Latin American women in Spain

This article focuses on the articulations of migration and gender, from the vantage point of women whose feminist experiences have been both enriched and challenged by migration and vice versa. It presents the results of a qualitative research study of five Latin American women who migrated to Barcelona and felt close to feminisms. The author draws on feminist and postcolonial approaches to migration studies that highlight the active role women play in migratory processes as well as how intersectional variables of ethnic origin, socioeconomic class, education and family contexts are articulated, configuring different power relations and resources in specific sociohistorical contexts. The results challenge widespread stereotypes about migrant women by revealing a rich diversity of profiles, motivations and migratory pathways, as well as how informants’ experiences of social activism across national borders have transformed their subject formation processes and re-positioned them as active subjects of political action.

Negotiating class, femininity and career: Latin American migrant women entrepreneurs in Spain

AbstractThis article analyses how the gendered and classed positions of migrant women explain the meanings of becoming an entrepreneur and the role of their spouses in their occupational trajectories. Using a translocational positionality approach, the article challenges the claim that women escape patriarchal domination by establishing their own businesses. The narratives of 35 Latin American women entrepreneurs in Spain reveal that becoming an entrepreneur is conditioned by class‐based ideas of masculinity and femininity. I argue that middle‐class Latin American immigrant women become entrepreneurs to promote their spouse's career advancement while conforming to class‐based norms of femininity. In contrast, lower class Latin American women view the business as a space of autonomy and occupational upward mobility that nevertheless also complies with working‐class definitions of femininity. The policy implications of these findings relate to making class aspirations central to the support of labour market integration and empowerment of migrant women.

Ethnic Differences in Visceral Adiposity Measured in Early Pregnancy.

To determine if visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) depth in early pregnancy differs by maternal ethnicity. We prospectively evaluated 482 women without pre-pregnancy diabetes. All underwent sonographic measurement of VAT and SAT depth at 11 to 14 weeks' gestation. SAT did not differ between groups, but VAT did. Compared with Canadian-born women (3.9 cm, 95% CI 3.7-4.1), mean VAT depth was higher among Latin American (4.6 cm, 95% CI 4.1-5.2), Sub-Saharan African (5.0 cm, 95% CI 4.0-6.1), and Caribbean (6.0 cm, 95% CI 4.8-7.3) women. Adjusting for age, parity, and 1/height2, the relative risks of having a VAT depth >80th percentile were 1.69 (95% CI 1.05-2.73) for Latin American, 2.24 (95% CI 1.28-3.93) for Sub-Saharan African, and 3.34 (95% CI 1.91-5.84) for Caribbean women, relative to Canadian-born women. Women from these world regions also had a greater percentage of preterm births and emergency CSs. VAT differs appreciably among certain ethnic groups, which may reflect their predisposition to adverse pregnancy outcomes.

Intervenciones públicas, configuraciones íntimas: escritoras latinoamericanas y caribeñas entre 1870 y 1940

The articles contained in the volume “Public Interventions, Intimate Configurations: Latin American and Caribbean Women Writers between 1870 and 1940” follow a tradition of feminist criticism focused on the recovery and visualization of the literary production of Latin American and Caribbean women writers.