A NARRATIVE ANALYSIS - A BLACK WOMANS PERCEPTIONS OF BREAST-CANCER RISKS AND EARLY BREAST-CANCER DETECTION

The oncology nurse's role in breast cancer management is enhanced by k nowledge of the patient's perceptions of risks. This case study elucid ates the process by which perceived risks of breast cancer are embedde d in sequences of biographic experiences including childhood sexual ab use, childhood injuries, and an abusive marriage. The case study shows that risk perceptions and subsequent delayed breast cancer defection is related to (a) a belief that breast cancer results from ''bad luck, or fate''; (b) lack of cancer related symptoms; (c) belief that a hig her power determines ill health; (d) reluctance to bunt to others for help while in an abusive marriage; (e)family history of cancer invulne rability since generations of family members died of diabetes, heart d isease, and pregnancy-related illnesses; and (f) fear of gynecologic e xams resulting from childhood sexual abuse. Furthermore, nonapplicabil ity of traditional breast cancer risk factors such as heredity, age ol der than 30 years at first full-term pregnancy early menarche, and lat e menopause prohibit an accurate assessment of self-risk. This case st udy suggests that breast cancer risk perception often differs from tha t of biomedical factors, and that an understanding of risk judgments i s essential for appropriate therapeutic responses.