The Experience of Recurrent Breast Cancer: A Case Study

Abstract

The purposes of this study were to describe, in-depth, the experience of recurrent breast cancer and to explore methodologies consistent with a conceptual orientation based in the Complex Nonlinear Dynamical Systems perspective and transitions. A single case study, longitudinal design was used. Eleven interviews were conducted over a three-month period. Daily Symptom Distress Scale scores and bi-weekly Mishel Uncertainty in Illness Scale scores were obtained. Interviews were analyzed using narrative analysis based on coherence structure, and scores were graphed individually for the entire time period and for each interview period. Based on the results of the analyses, it was concluded that the time following the diagnosis of breast cancer recurrence was one of biographical disruption for the individual participating in the study. Critical points in the interviews were identified that marked the beginning of a new biography that the woman came to narrate. Furthermore, the recurrence experience was different than the initial experience in many ways. The graphs of quantitative data showed some areas of correspondence with the interview analysis, but not consistently so. The graphs were interpreted within the context of the narrative analysis. The three major findings to emerge were (1) diagnosis of recurrent breast cancer was a disruptive event followed by a period of disorganization and subsequent reorganization, (2) a sense of anticipated "againness" was perceived as making the second time harder, and (3) methodologies selected were useful in the investigation of this complex phenomena of transition from a Complex Nonlinear Dynamical Systems perspective.