Skip to main content

Advertisement

Log in

“An addendum to breast cancer”: the triple negative experience

Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

The triple negative breast cancer (TNBC) subtype, known to be aggressive with high recurrence and mortality rates, disproportionately affects African-Americans, young women, and BRCA1 carriers. TNBC does not respond to hormonal or biologic agents, limiting treatment options. The unique characteristics of the disease and the populations disproportionately affected indicate a need to examine the responses of this group. No known studies describe the psychosocial experiences of women with TNBC. The purpose of this study is to begin to fill that gap and to explore participants’ psychosocial needs.

Method

An interpretive descriptive qualitative approach was used with in-depth interviews. A purposive sample of adult women with TNBC was recruited. Dominant themes were extracted through iterative and constant comparative analysis.

Results

Of the 22 participants, nearly half were women of color, and the majority was under the age of 60 years and within 5 years of diagnosis. The central theme was a perception of TNBC as “an addendum” to breast cancer. There were four subthemes: TNBC is Different: “Bottom line, it’s not good”; Feeling Insecure: “Flying without a net”; Decision-Making and Understanding: “A steep learning curve”; and Looking Back: “Coulda, shoulda, woulda.” Participants expressed a need for support in managing intense uncertainty with a TNBC diagnosis and in decision-making.

Conclusions

Women with all subtypes of breast cancer have typically been studied together. This is the first study on the psychosocial needs specifically of women with TNBC. The findings suggest that women with TNBC may have unique experiences and unmet psychosocial needs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

References

  1. DeSantis CE, Lin CC, Mariotto AB, Siegel RL, Stein KD, Kramer JL et al (2014) Cancer treatment and survivorship statistics, 2014. CA Cancer J Clin 64(4):252–271

    Article  PubMed  Google Scholar 

  2. American Cancer Society (2014). Breast cancer: Detailed guide. http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-key-statistics. Accessed 24 March 2014

  3. Siegel R, Ma J, Zou Z, Jemal A (2014) Cancer statistics, 2014. CA Cancer J Clin 64(1):9–29

    Article  PubMed  Google Scholar 

  4. Turkman YE, Sakibia Opong A, Harris LN, Knobf MT (2015) Biologic, demographic, and social factors affecting triple negative breast cancer outcomes. Clin J Oncol Nurs 19(1):62–67

    Article  PubMed  Google Scholar 

  5. Fornier M, Fumoleau P (2012) The paradox of triple negative breast cancer: novel approaches to treatment. Breast J 18(1):41–51

    Article  PubMed  Google Scholar 

  6. Brouckaert O, Wildiers H, Floris G, Neven P (2012) Update on triple-negative breast cancer: prognosis and management strategies. Int J Womens Health 4:511–520

    PubMed  PubMed Central  Google Scholar 

  7. Wright JL, Reis IM, Zhao W, Panoff JE, Takita C, Sujoy V et al (2012) Racial disparity in estrogen receptor positive breast cancer patients receiving trimodality therapy. Breast 21(3):276–283

    Article  CAS  PubMed  Google Scholar 

  8. Knobf MT (2011) Clinical update: psychosocial responses in breast cancer survivors. Semin Oncol Nurs 27(3):e1–e14

    Article  PubMed  Google Scholar 

  9. Reyes-Gibby CC, Anderson KO, Morrow PK, Shete S, Hassan S (2012) Depressive symptoms and health-related quality of life in breast cancer survivors. J Womens Health (Larchmt) 21(3):311–318

    Article  Google Scholar 

  10. Harrington CB, Hansen JA, Moskowitz M, Todd BL, Feuerstein M (2010) It’s not over when it’s over: long-term symptoms in cancer survivors--a systematic review. Int J Psychiatry Med 40(2):163–181

    Article  PubMed  Google Scholar 

  11. Rao D, Debb S, Blitz D, Choi SW, Cella D (2008) Racial/ethnic differences in the health-related quality of life of cancer patients. J Pain Symptom Manage 36(5):488–496

    Article  PubMed  PubMed Central  Google Scholar 

  12. Ashing-Giwa K, Lim JW (2011) Examining emotional outcomes among a multiethnic cohort of breast cancer survivors. Oncol Nurs Forum 38(3):279–288

    Article  PubMed  Google Scholar 

  13. Adams E, McCann L, Armes J, Richardson A, Stark D, Watson E et al (2011) The experiences, needs and concerns of younger women with breast cancer: a meta-ethnography. Psychooncology 20(8):851–861

    Article  PubMed  Google Scholar 

  14. Ruddy KJ, Partridge AH (2012) Treatment of breast cancer in young women. Clin Pract 9(2):171–180

    Article  Google Scholar 

  15. Howard-Anderson J, Ganz PA, Bower JE, Stanton AL (2012) Quality of life, fertility concerns, and behavioral health outcomes in younger breast cancer survivors: a systematic review. J Natl Cancer Inst 104(5):386–405

    Article  PubMed  Google Scholar 

  16. Janz NK, Hawley ST, Mujahid MS, Griggs JJ, Alderman A, Hamilton AS et al (2011) Correlates of worry about recurrence in a multiethnic population-based sample of women with breast cancer. Cancer 117(9):1827–1836

    Article  PubMed  PubMed Central  Google Scholar 

  17. Canada AL, Schover LR (2012) The psychosocial impact of interrupted childbearing in long-term female cancer survivors. Psychooncology 21(2):134–143

    Article  PubMed  Google Scholar 

  18. Gabriel CA, Domchek SM (2010) Breast cancer in young women. Breast Cancer Res 12(5):212

    Article  PubMed  PubMed Central  Google Scholar 

  19. Polit DF, Beck CT (2012) Nursing research: generating and assessing evidence for nursing practice, 9th edn. Lippincott, Williams & Wilkins, Philadelphia

    Google Scholar 

  20. Creswell JW (2007) Qualitative inquiry and research design: choosing among five approaches, 2nd edn. Sage Publications, Inc, Thousand Oaks

    Google Scholar 

  21. Thorne S, Kirkham SR, MacDonald-Emes J (1997) Interpretive description: a noncategorical qualitative alternative for developing nursing knowledge. Res Nurs Health 20(2):169–177

    Article  CAS  PubMed  Google Scholar 

  22. Thorne S, Kirkham SR, O’Flynn-Magee K (2004) The analytic challenge in interpretive description. Int J Qual Methods 3(1):1–11

    Google Scholar 

  23. Thorne S (2008) Interpretive description. Left Coast Press, Inc, Walnut Creek

    Google Scholar 

  24. Lincoln YS, Guba EG (1985) Naturalistic inquiry. Sage, Hollywood

    Google Scholar 

  25. Czaja R, Manfredi C, Pierce J (2003) The determinants and consequences of information seeking among cancer patients. J Health Commun 8:529–562

    Article  PubMed  Google Scholar 

  26. Germino BB, Mishel MH, Crandell J, Porter L, Blyler D, Jenerette C et al (2013) Outcomes of an uncertainty management intervention in younger African American and Caucasian breast cancer survivors. Oncol Nurs Forum 40(1):82–92

    Article  PubMed  Google Scholar 

  27. Hall DL, Mishel MH, Germino BB (2014) Living with cancer-related uncertainty: associations with fatigue, insomnia, and affect in younger breast cancer survivors. Support Care Cancer 22(9):2489–95

    Article  PubMed  Google Scholar 

  28. Sammarco A (2009) Quality of life of breast cancer survivors: a comparative study of age cohorts. Cancer Nurs 32(5):347–56

    Article  PubMed  Google Scholar 

  29. Garofalo JP, Choppala S, Hamann HA, Gjerde J (2009) Uncertainty during the transition from cancer patient to survivor. Cancer Nurs 32(4):E8–E14

    Article  PubMed  PubMed Central  Google Scholar 

  30. Mollica M, Nemeth L, Newman SD, Mueller M (2014) Quality of life in African American breast cancer survivors: an integrative literature review. Cancer Nurs 38(3):194–204

    Article  Google Scholar 

  31. Buzaglo JS, Miller SM, Kendall J, Stanton AL, Wen KY, Scarpato J et al (2013) Evaluation of the efficacy and usability of NCI’s Facing Forward booklet in the cancer community setting. J Cancer Surviv 7(1):63–73

    Article  PubMed  Google Scholar 

  32. Spittler CA, Pallikathayil L, Bott M (2012) Exploration of how women make treatment decisions after a breast cancer diagnosis. Oncol Nurs Forum 39(5):E425–33

    Article  PubMed  Google Scholar 

  33. Budden LM, Hayes BA, Buettner PG (2014) Women’s decision satisfaction and psychological distress following early breast cancer treatment: a treatment decision support role for nurses. Int J Nurs Pract 20(1):8–16

    Article  PubMed  Google Scholar 

  34. Kokufu H (2012) Conflict accompanying the choice of initial treatment in breast cancer patients. Jpn J Nurs Sci 9(2):177–184

    Article  PubMed  Google Scholar 

  35. Taylor A, Tischkowitz M (2014) Informed decision-making is the key in women at high risk of breast cancer. Eur J Surg Oncol 40(6):667–669

    Article  CAS  PubMed  Google Scholar 

  36. Hack TF, Carlson L, Butler L, Degner LF, Jakulj F, Pickles T et al (2011) Facilitating the implementation of empirically valid interventions in psychosocial oncology and supportive care. Support Care Cancer 19(8):1097–1105

    Article  PubMed  Google Scholar 

  37. Seror V, Cortaredona S, Bouhnik AD, Meresse M, Cluze C, Viens P et al (2013) Young breast cancer patients’ involvement in treatment decisions: the major role played by decision-making about surgery. Psychooncology 22(11):2546–2556

    Article  PubMed  Google Scholar 

  38. Matthews AK, Tejeda S, Johnson TP, Berbaum ML, Manfredi C (2012) Correlates of quality of life among African American and white cancer survivors. Cancer Nurs 35(5):355–364

    Article  PubMed  PubMed Central  Google Scholar 

  39. Lam WW, Chan M, Or A, Kwong A, Suen D, Fielding R (2013) Reducing treatment decision conflict difficulties in breast cancer surgery: a randomized controlled trial. J Clin Oncol 31(23):2879–2885

    Article  PubMed  Google Scholar 

  40. Stacey D, Legare F, Col NF, Bennett CL, Barry MJ, Eden KB et al (2014) Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev 1:CD001431

    PubMed  Google Scholar 

Download references

Acknowledgments

This study was funded in part by the Susan G. Komen Foundation Training in Disparities Research Grant and American Cancer Society Doctoral Degree Scholarship in Cancer Nursing, DSCN-12-203-01-SCN. The authors gratefully acknowledge the editorial comments of Elayne K. Phillips, PhD, RN, FAAN.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yasemin E. Turkman.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Turkman, Y.E., Kennedy, H.P., Harris, L.N. et al. “An addendum to breast cancer”: the triple negative experience. Support Care Cancer 24, 3715–3721 (2016). https://doi.org/10.1007/s00520-016-3184-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-016-3184-4

Keywords

Navigation