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Thoughts Matter Immediately after a Breast Cancer Diagnosis, According to UB Study

Threatened self-integrity was identified as a main concern

Release Date: September 9, 2010

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The effect of a cancer diagnosis on a woman's self concept is not something that health care providers consider shortly after diagnosis, says Robin Lally.

BUFFALO, N.Y. -- What goes through a woman's mind when she first hears the words, "You have breast cancer"? One in eight women will hear those words at some point in their lives and yet very little research has been conducted about women's thoughts at this early stage before treatment or surgery.

The ways women move from becoming a "breast cancer patient" immediately after diagnosis to integrating cancer into their understanding of themselves is revealed in a new study published in one of the nation's top nursing journals, Cancer Nursing, by University at Buffalo researcher, Robin Lally, PhD, RN, an assistant professor in the UB School of Nursing.

"The effect of a cancer diagnosis on a woman's self concept is not something that health care providers often consider when they are focused on the physical aspects of the disease and treatment early after diagnosis," Lally explains.

Her study reveals how women acclimate to their diagnosis as they adapt to a new world, a foreign environment, in which there are new roles and new people with a new culture and strange words.

The study found that "threatened self-integrity" -- the threat to how we know ourselves -- is the main concern for women as they acclimated to being "breast cancer patients" or "survivors." The women's self-integrity also was threatened by how they perceived others' impressions of them and by whether they attributed developing cancer to their own actions or inaction.

From the findings, Lally has developed a theory of acclimating to breast cancer that focuses on three stages to the initial adjustment process: surveying the situation, taking action and the emerging self.

Her findings may help health providers better understand the thought process of women as they come to grips with the meaning of breast cancer in their lives as early as a week or two after discovering they have the disease.

"These women should know they are not alone in their thinking, that their initial thoughts are not abnormal; they are shared by others in the early days after being diagnosed," Lally says.

For the study, Lally interviewed 18 women aged 37 to 87 diagnosed with stage 0 to stage II breast cancer. The women were interviewed within six to 21 days after the diagnosis and were asked to think back to the day they were diagnosed with breast cancer and share their experiences.

Essentially, according to Lally, women will work through a period of internal reflection about how breast cancer will affect them and those around them ("I have something that others dread"), to taking control of their immediate environments (reducing negative thoughts and using distraction) to incorporating cancer into their lives and contemplating the future.

In fact, many women in Lally's study embraced personal change and saw the diagnosis as "a wake-up call" to appreciate life and the people in it. For the most part, women felt optimistic and hopeful that they would survive their cancer, Lally says.

At the end of the study, Lally was surprised to discover the "amount of mental energy that women expend when thinking about their diagnosis and strategies to control their environment" as a way to protect themselves from uncomfortable moments that arise when they are the "cancer patient" in social and work situations.

The University at Buffalo is a premier research-intensive public university, a flagship institution in the State University of New York system and its largest and most comprehensive campus. UB's more than 28,000 students pursue their academic interests through more than 300 undergraduate, graduate and professional degree programs. Founded in 1846, the University at Buffalo is a member of the Association of American Universities.

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