The meaning of breast cancer

Breast cancer patients' perception of illness could influence preferences in decision-making. According to Lipowsky, the meaning of illness might influence coping abilities and he suggests eight categories of meaning as prevalent in our culture: 'challenge', 'enemy', 'punishment', 'weakness', 'irreparable loss', 'relief', 'strategy' and 'value'. In this study 187 Swedish breast cancer patients chose one of these eight categories as their meaning of breast cancer. 'Challenge' was chosen most often, by 33% of all patients and by 40% of patients in middle life (51-65 years). Older patients (> or = 66 years) chose 'challenge' less frequently (17%) but chose 'relief', 'strategy' or 'value' more often than younger patients. The few patients with metastatic disease chose 'enemy', 'punishment', 'weakness' and 'irreparable loss' more often than patients in the earlier stages of disease. There were differences in perception of illness depending on patients' age and stage of disease but not depending on their preferences in decision-making.