Breast Cancer Screening: Women's Experiences of Waiting for Further Testing

Patricia Pineault

cancer screening, breast cancer, women, social support
ONF 2007, 34(4), 847-853. DOI: 10.1188/07.ONF.847-853

Purpose/Objectives: To describe anxiety experienced by participants in a breast cancer screening program who have received an abnormal screening mammography result and are waiting for further testing and diagnosis and to identify the social support needed during this period.

Design: Exploratory, descriptive.

Setting: Quebec Breast Cancer Screening Program (QBCSP) participants in Montreal, Canada.

Sample: Nonprobability sample of 631 asymptomatic women, aged 50-69, who had abnormal screening mammogram results in the two months prior to the survey and who spoke or read French or English.

Methods: Mailed self-report questionnaire.

Main Research Variables: Anxiety, social support, and breast cancer screening.

Findings: Fifty-one percent of the participants were quite or very anxious at every stage of the prediagnostic phase. Seventy-five percent expressed their feelings to family and friends whose support was comforting but did not diminish participants' anxiety. Satisfaction from social support offered by healthcare professionals reduced their anxiety.

Conclusions: To decrease anxiety in the prediagnostic phase, women need support from healthcare professionals during the early stage of the screening process to prevent exacerbation of their concerns. Support has to be integrated into a continuity-of-care process.

Implications for Nursing: Nurses can play a significant role in breast cancer screening programs. They can evaluate, at an early stage, participant anxiety and offer the appropriate social support. They also can ensure the follow-up and personalized support required while a patient awaits a diagnosis.

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    Aro, A.R., Absetz, S.P., van Elderen, T.M., van der Ploeg, E., & van der Kamp, L.J. (2000). False-positive findings in mammography screening induces short-term distress—Breast cancer-specific concern prevails longer. European Journal of Cancer, 36, 1089-1097.
    Bakker, D.A., Lightfoot, N.E., Steggles, S., & Jackson, C. (1998). The experience and satisfaction of women attending breast cancer screening. Oncology Nursing Forum, 25, 115-121.
    Barrera, M., Sandler, I.N., & Ramsay, T.B. (1981). Preliminary development of a scale of social support: Study on college students. American Journal of Community Psychology, 9, 435-447.
    Benedict, S., Williams, R.D., & Baron, P.L. (1994). Recalled anxiety: From discovery to diagnosis of a benign breast mass. Oncology Nursing Forum, 4, 1723-1727.
    Brett, J., & Austoker, J. (2001). Women who are recalled for further investigation for breast screening: Psychological consequences three years after recall and factors affecting re-attendance. Journal of Public Health Medicine, 23, 292-300.
    Brett, J., Bankhead, C., Henderson, B., Watson, E., & Austoker, J. (2005). The psychological impact of mammography screening: A systematic review. Psycho-Oncology, 14, 917-938.
    Caplan, G. (1974). Support systems and community mental health. New York: Human Sciences Press.
    Cockburn, J., De Luise, T., Hurley, S., & Clover, K. (1992). Development and validation of the PCQ: A questionnaire to measure the psychological consequences of screening mammography. Social Sciences and Medicine, 24, 1129-1134.
    Deane, K.A., & Degner, L.F. (1997). Determining the information needs of women after breast biopsy procedures. AORN Journal, 65, 767-776.
    Deane, K.A., & Degner, L.F. (1998). Information needs, uncertainty, and anxiety in women who had a breast biopsy with benign outcome. Cancer Nursing, 21, 117-126.
    De Grasse, C.E., Hugo, K., & Plotnikoff, R. (1997). Supporting women during breast diagnostic. Canadian Nurse, 93, 24-30.
    Dolan, N.C., Feinglass, J., Priyanath, A., Haviley, C., Sorensen, A.V., & Venta, L.A. (2001). Measuring satisfaction with mammography results reporting. Journal of General Internal Medicine, 16, 157-162.
    Drageset, S., & Lindstrom, T.C. (2003). The mental health of women with suspected breast cancer: The relationship between social support, anxiety, coping and defense in maintaining mental health. Journal of Psychiatric and Mental Health Nursing, 10, 401-409.
    Elkind, A., & Eardley, A. (1990). Consumer satisfaction with breast screening: A pilot study. Journal of Public Health Medicine, 12(1), 15-18.
    Fridfinnsdottir, E.B. (1997). Icelandic women's identification of stressors and social support during the diagnostic phase of breast cancer. Journal of Advanced Nursing, 25, 526-531.
    Hislop, T.G., Harris, S.R., Jackson, J., Thorne, S.E., Rousseau, E.J., Coldman, A.J., et al. (2002). Satisfaction and anxiety for women during investigation of an abnormal screening mammogram. Breast Cancer Research and Treatment, 76, 245-254.
    Hurley, S.F., & Kaldor, J.M. (1992). The benefits and risks of mammography screening for breast cancer. Epidemiologic Reviews, 14, 101-130.
    Lampic, C., Thurfjell, E., Bergh, J., & Sjoden, P.O. (2001). Short- and long-term anxiety and depression in women recalled after breast cancer screening. European Journal of Cancer, 37, 463-469.
    Lowe, J.B., Balanda, K.P., Del Mar, C., & Hawes, E. (1999). Psychologic distress in women with abnormal findings in mass mammography screening. Cancer, 85, 1114-1118.
    Marteau, T.M. (1990). Screening in practice: Reducing the psychological costs. British Medical Journal, 301, 26-28.
    Marteau, T.M. (1994). Psychology and screening: Narrowing the gap between efficacy and effectiveness. British Journal of Clinical Psychology, 33, 1-10.
    Meystre-Agustoni, G., Paccaud, F., Jeannin, A., & Dubois-Arber, F. (2001). Anxiety in a cohort of Swiss women participating in a mammography screening programme. Journal of Medical Screening, 8, 213-219.
    Ministère de la santé et des services sociaux. (1996). Programme québécois de dépistage du cancer du sein: cadre de référence [Quebec program of screening of the cancer of the breast: reference framework]. General direction of public health. Montreal, Canada: Author.
    Ministère de la santé et des services sociaux. (2005). Bilan 1998-2003: Programme québécois de dépistage du cancer du sein [Report 1998-2003: Quebec program of screening of the cancer of the breast]. Direction of the communications. Montreal, Canada: Author.
    Northouse, L.L., Jeffs, M., Cracchiolo-Caraway, A., Lampman, L., & Dorris, G. (1995). Emotional distress reported by women and husbands prior to a breast biopsy. Nursing Research, 44, 196-201.
    O'Mahony, M. (2001). Women's lived experience of breast biopsy: A phenomenological study. Journal of Clinical Nursing, 10, 512-520.
    Ong, G., & Austoker, J. (1997). Recalling women for further investigation of breast screening: Women's experiences at the clinic and afterwards. Journal of Public Health Medicine, 19(1), 29-36.
    Ong, G., Austoker, J., & Brett, J. (1997). Breast screening: Adverse psychological consequences one month after placing women on early recall because of a diagnostic uncertainty: A multicentre study. Journal of Medical Screening, 4, 158-168.
    Pineault, P. (2001). L'expérience de femmes, de 50 à 69 ans, en attente de résultats d'examens complémentaires suite à une mammographie de dépistage de cancer du sein anormale [The experience of women, of 50 to 69 years, in expectation of results of supplementary examinations after a screening mammography for cancer of the abnormal breast]. Unpublished master's thesis, Université de Montréal.
    Poole, K., Hood, K., Davis, B.D., Monypenny, I.J., Sweetland, H., Webster, D.J., et al. (1999). Psychological distress associated with waiting for results of diagnostic investigations for breast disease. Breast, 8, 334-338.
    Poole, K., & Lyne, P.A. (2000). The cues to diagnosis: Describing the monitoring activities of women undergoing diagnostic investigations for breast disease. Journal of Advanced Nursing, 31, 752-758.
    Sandin, B., Chorot, P., Valiente, R.M., Lostao, L., & Santed, M.A. (2002). Anticipatory anxiety in women recalled for further mammogram breast cancer screening. Psychology in Spain, 6, 61-67.
    Scaf-Klomp, W., Sanderman, R., van de Wiel, H.B., Otter, R., & van den Heuvel, W.J. (1997). Distressed or relieved? Psychological side effects of breast cancer screening in the Netherlands. Journal of Epidemiology and Community Health, 51, 705-710.
    Schaefer, C., Coyne, J.C., & Lazarus, R.S. (1981). The health-related functions of social support. Journal of Behavioral Medicine, 4, 381-406.
    Seckel, M.M., & Birney, M.H. (1996). Social support, stress, and age in women undergoing breast biopsies. Clinical Nurse Specialist, 10, 137-143.
    Smith, C.E., Fernengel, K., Holcroft, C., & Gerald, K. (1994). Meta-analysis of the associations between social support and health outcomes. Social Support and Health Outcomes, 16, 352-362.
    Thorne, S.E., Harris, S.R., Hislop, T.G., & Vestrup, J.A. (1999). The experience of waiting for diagnosis after an abnormal mammogram. Breast Journal, 5, 42-51.