Facchin Federica, Scarfone Giovanna, Tamanza Giancarlo, Ravani Silvia, Francini Federica, Peccatori Fedro Alessandro, Di Loreto Eugenia, Dell'Acqua Andrea, Saita Emanuela
Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy.
Gynecology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
Front Psychol. 2021 Apr 1;12:620353. doi: 10.3389/fpsyg.2021.620353. eCollection 2021.
Cancer diagnosed during pregnancy is a rare event. The most common type of malignancy diagnosed in pregnant women is breast cancer, whose incidence is expected to raise in the next future due to delayed childbirth, as well as to the increased occurrence of the disease at young age. Pregnant women diagnosed with breast cancer are exposed to multiple sources of stress, which may lead to poorer obstetric outcomes, such as preterm birth and low birth weight. In addition, pregnancy involves physiological changes in the breasts that may blur the signs of cancer, with delayed diagnosis and poor prognosis. However, the lived experience of these women was investigated in very few studies. Given this scenario, we conducted this qualitative study to describe and understand women's subjective experience of being diagnosed with breast cancer during pregnancy. The study was conducted following the principles of Interpretative Phenomenological Analysis. Participants were five women with breast cancer diagnosed during pregnancy, purposefully recruited at a public hospital during medical visits and interviewed at treatment initiation. The interview transcripts were analyzed using thematic analysis. The textual analysis led to the identification of three main themes related to: (1) the emotional storm experienced after cancer diagnosis, and the importance of receiving appropriate information and being focused on treatment decisions; (2) physical changes and comparisons with healthy women, associated with feelings of sadness and inadequacy; (3) being positive, feeling free to disclose all kinds of emotions, religion and spirituality as sources of strength. The paradoxical coexistence of pregnancy and cancer represents a stressful experience for women and their loved ones. Adopting a systemic perspective may be important to understand the effects of such a complex condition, also considering its impact on healthcare workers.
孕期诊断出癌症是罕见事件。孕妇中诊断出的最常见恶性肿瘤类型是乳腺癌，由于生育推迟以及该疾病在年轻人群中发病率上升，预计其发病率在未来还会增加。被诊断出患有乳腺癌的孕妇面临多种压力源，这可能导致较差的产科结局，如早产和低体重出生。此外，怀孕会使乳房发生生理变化，这可能会掩盖癌症迹象，导致诊断延迟和预后不良。然而，针对这些女性的生活经历的研究却非常少。鉴于这种情况，我们开展了这项定性研究，以描述和理解女性在孕期被诊断出患有乳腺癌的主观体验。该研究遵循解释现象学分析的原则进行。参与者是五名在孕期被诊断出患有乳腺癌的女性，她们是在公立医院就诊时被有目的地招募的，并在开始治疗时接受了访谈。访谈记录采用主题分析法进行分析。文本分析得出了三个主要主题：（1）癌症诊断后经历的情绪风暴，以及获得适当信息并专注于治疗决策的重要性；（2）身体变化以及与健康女性的比较，伴有悲伤和不足感；（3）保持积极心态，自由地披露各种情绪，将宗教和精神信仰作为力量源泉。怀孕和癌症的矛盾共存对女性及其亲人来说是一种压力体验。采用系统的视角对于理解这种复杂状况的影响可能很重要，同时也要考虑到它对医护人员的影响。
