Breast Cancer Symptoms Appraisal by Iranian Women: A Qualitative Study

Background: Breast cancer is the most common cancer in Iranian women and usuallyfeatures delayed presentation and late diagnosis. Interpretation of symptoms, as the mostimportant step, has a significant impact on patient delay in seeking treatment. This studyexplored the perceptions and experiences of Iranian women with self-detected possiblebreast cancer symptoms. A qualitative method was conducted involving in-depth semistructuredinterviews with 27 Iranian women with self-discovered breast cancer symptoms.Participants were purposefully selected from women who attended Cancer Institute of TehranUniversity of Medical Sciences during June 2012 to August 2013. The audiotaped interviewswere transcribed and analyzed using conventional content analysis with MAXQDA soft wareversion 10. The trustworthiness of the study was verified by prolonged engagement, membervalidation of codes, and thick description. The main concepts emerging from data analysiswere categorized in four categories: symptom recognition, labeling of symptoms, interactiveunderstanding, and confronting the fear of cancer. Symptom recognition through breast selfexamination,symptom monitoring and employing prior knowledge distinguished normal fromabnormal symptoms and accompanied with perception of being at risk of breast cancer led tosymptom labelling. Perceived seriousness of the situation and social meanings of breastcancer as a stigmatized and incurable illness associated with loss of femininity were reasonsfor patient worries and fear. This study emphasized that entangled cognitive, emotional andsocio-cultural responses affecting understanding of symptom seriousness require furtherinvestigation. It is suggested that programs aimed at shortening patient delay in breast cancershould be focused on improving women’s knowledge and self-awareness of breastcancer, in addition to correcting their social beliefs.

Keywords:

Breast Cancer , Symptom Appraisal , Women , Qualitative Study , Iran