Punjabi women's stories of breast cancer symptoms: Gulti (lumps), bumps, and Darad (pain).

The purpose of this study was to examine experiences related to self-discovered breast cancer symptoms from the perspective of Punjabi immigrant women residing in Canada. Interviews were conducted with 25 women, 19 of whom had received a diagnosis of breast cancer. Using narrative analysis, 4 types of stories were identified. In the stories that were based on constructions of breast symptoms as "nothing serious," women emphasized that they had not even considered the possibility of breast cancer and were encouraged to dismiss concerns about their health. Stories focusing on suspicions about the presence of a health problem included descriptions of mounting concern and tension as the women began to realize that the breast symptoms they experienced might not be of the regular or normal variety. In stories dominated by worry, vivid descriptions of fears of breast cancer were juxtaposed with explanations about how women protected family members by downplaying their symptoms. Finally, in stories that focused on gaining strength in readiness to deal with whatever may lie ahead, women drew on the support of their extended families, their religious beliefs, and their need to care for their families. These findings provide a basis for guiding the development of culturally appropriate health education for Punjabi women.