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Breast cancer confessions: The emotional work of disclosing a diagnosis

August 04, 2008

Sociological research examines how women relate their breast cancer diagnosis to loved ones; concludes that disclosure is 'work'

BOSTON - Women diagnosed with breast cancer shoulder the emotional burden of disclosing their diagnosis to loved ones, managing the feelings of others at precisely the time when they need support themselves, according to research to be presented at the annual meeting of the American Sociological Association (ASA).

The research is the first study to comparatively and qualitatively examine how breast cancer survivors from different racial and ethnic backgrounds share the news of their illness with family, friends and acquaintances. The researchers interviewed 164 breast cancer survivors to examine the "emotion work" involved in disclosing a breast cancer diagnosis. These survivors included a mix of racially diverse women born in the United States and immigrants, and they were recruited throughout the San Francisco Bay area.

"Women diagnosed with breast cancer face an uphill emotional battle," said Grace J. Yoo, a sociologist at San Francisco State University and the study's primary investigator. "At a time when they are forced to deal with their own vulnerabilities, women with breast cancer must also navigate the vulnerabilities of loved ones as they react to the news."

For women-typically perceived as caregivers and expected to put the emotions of others above their own-a breast cancer diagnosis presents a paradox, according to Yoo. Women must face the challenge of determining how to ask for help from others when they are typically seen as the caregiver.

According to interviews with breast cancer survivors, different strategies were employed in conversations with close family members compared to those outside the family. Survivors viewed informing their family of the diagnosis as their most difficult task following a diagnosis. Most respondents felt the need to strategically manage the way family members were told in order to protect their loved ones and to provide comfort and reassurance.

Contrary to the approach they used with their families, women often related their diagnosis to peers spontaneously. Most respondents were surprised by the extent of the support they received as a result of these unplanned conversations and by the depth and breadth of their own social networks.

"Women who limit their emotions in discussing their breast cancer diagnosis often limit the possibilities for support they can receive," said Yoo. "Involving and including others in an illness increases intimacy among friends and family and opens the door to additional support."

Yoo co-authored the study with researchers Caryn Aviv from the University of Denver; Ellen G. Levine of San Francisco State University; and Cheryl Ewing and Alfred Au, both of the UCSF Comprehensive Cancer Center.

American Sociological Association