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Access Type
WSU Access
Date of Award
January 2025
Degree Type
Dissertation
Degree Name
Ph.D.
Department
Nursing
First Advisor
Rick Zimmerman
Abstract
Background: In the U.S., cancer remains a significant public health challenge, with an estimated 1.9 million new cases diagnosed in 2024 alone. Among women, breast cancer is the most diagnosed cancer. It disproportionately affects African American women, who face higher mortality rates and are often diagnosed at later stages compared to other racial groups. Mastectomy, a standard treatment, significantly impacts body image and quality of life. Despite the availability of breast reconstruction as an option, African American women are less likely to pursue it, often due to personal, cultural, and systemic factors. Purpose: The study aimed to explore the lived experiences of African American women who underwent mastectomy without breast reconstruction. Four research questions guided the study: 1) What is the experience of African American women with breast cancer who had a mastectomy without breast reconstruction? 2) Why do African American women choose not to undergo breast reconstruction after mastectomy? 3) How does mastectomy impact their body image and quality of life? 4) Was breast reconstruction considered a viable option? Methods: This qualitative study employed van Manen’s phenomenological method to explore participants' lived experiences. Data were collected from July to September 2024 through semi-structured, in-depth interviews with 10 African American women recruited via purposeful sampling from Sister’s Network Greater Metropolitan Detroit Chapter (SNGMDC). A demographic survey was conducted, and interviews were conducted in private, comfortable settings chosen by the participants. Interviews followed a flexible, semi-structured format to capture rich, detailed narratives and were audio-recorded with participants’ consent. Transcriptions were coded and analyzed using NVivo 15 software. Thematic analysis using van Manen’s method was conducted to uncover themes and experiential structures embodying the evolving meanings of the participants’ experiences. This process involved iterative coding, reflection, and validation through member checking and peer review. Contextual details, including nonverbal cues, were incorporated to enrich the data. Analysis continued until saturation was reached, ensuring a comprehensive representation of participants’ lived experiences. Results: Seventeen themes emerged from the analysis: 1) experiences with treatment options and preoperative knowledge, 2) rationales for and postoperative experiences of mastectomy, 3) the moment of diagnosis, 4) experiencing recurrence, 5) post-diagnosis experiences and hesitations, 6) personal motivations, 7) physicians’ attitudes and influence, 8) stories from survivors, family, and support groups, 9) impact on body image, 10) post-mastectomy life, 11) use of prosthetic breasts, 12) psychological impact, 13) influence of religious beliefs, 14) determinants of reconstruction decisions, 15) influences from others’ experiences, 16) initial consideration and subsequent change of mind, and 17) indecision and uncertainty. Implications: This study provides valuable insights into the complex factors influencing African American women’s decisions and experiences with mastectomy without reconstruction. The findings suggest the need for culturally sensitive healthcare approaches prioritizing individualized communication, education, and support. Educational programs, therefore, should address the unique sociocultural and religious contexts of African American women to improve decision-making frameworks and promote more significant equity in healthcare delivery.
Recommended Citation
Gborogen, Rosilyn Abinor, "Experience Of African American Women With Mastectomy Without Breast Reconstruction" (2025). Wayne State University Dissertations. 4201.
https://digitalcommons.wayne.edu/oa_dissertations/4201