Patient perspectives on the causes of breast cancer: a qualitative study on the relationship between stress, trauma, and breast cancer development

Erica Niebauer,Nina Fry,Lisa A Auster-Gussman,Helané Wahbeh

doi:10.1080/17482631.2021.1983949

Abstract

ABSTRACT Purpose: We qualitatively evaluated breast cancer survivors’ perception of the relation between breast cancer development and both childhood trauma and stressful life events in adulthood. Methods: Women (N = 50) who have or had a positive breast cancer diagnosis completed a close-ended survey, a timeline of significant life events, and an in-depth interview. All interviews were transcribed and inductively coded using thematic analysis with an emphasis on patient perspectives of illness. Results: Participants reported a perceived connection between breast cancer development and stressful life events, and four themes were identified: 1) experiencing major interpersonal stress in both childhood and adulthood, 2) ideas about the relationship between emotional stress and physical disease, 3) ideas about how different types of stress contribute to developing breast cancer, 4) post-treatment post-traumatic growth and meaning-making. Conclusions: Our findings suggest that of the participants who felt something could be causally attributed to their developing breast cancer, most of them made causal attributions between social, personal, and physical stress and trauma across the lifetime to the aetiology of their breast cancer. We suggest that breast cancer patients and survivors may benefit from additional psycho-social, stress-reducing, and/or somatic-based trauma-informed therapies to address stress and trauma.

Highlights

Breast Cancer is the most common cancer diagnosis in women worldwide (WHO, 2021)
Women who reported more adverse childhood experiences (ACES), such as emotional, sexual, or physical abuse or approximation to mental illness or addiction, had higher odds of cancer diagnosis, this study was not limited to breast cancer (Alcala et al, 2017)
The results suggest that breast cancer patients perceive that their stress and trauma experiences and lifetime interpersonal social conflict contributed to their breast cancer development and course

Summary

Introduction

The World Health Organization estimated that 2,261,419 women were diagnosed with, and 684,996 women died from breast cancer in 2020 (WHO, 2021). Women who reported more adverse childhood experiences (ACES), such as emotional, sexual, or physical abuse or approximation to mental illness or addiction, had higher odds of cancer diagnosis, this study was not limited to breast cancer (Alcala et al, 2017). Experience of childhood emotional abuse is related to more intrusive breast cancer symptoms (Goldsmith et al 2006), whereas women without stress or trauma history have been shown to have slower disease progression than those with a history of one or more incidents (Palesh et al, 2007). Breast cancer patients who experienced childhood sexual abuse reported feeling triggered and reminded of past abuse during treatment (Schnur et al 2017, Gallo-Silver et al, 2006) and having less supportive relationships with their healthcare team (Clark et al 2011)

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