"It Is What It Is" - The Lived Experience of Women With Breast Cancer Undergoing Axillary Lymph Node Dissection.

Abstract

Purpose: The lived experience of women undergoing axillary procedures as part of their breast cancer (BC) treatment remains unexplored. This lack of in-depth understanding could hamper implementation of person-centred care, which is concerning because BC is the most common form of cancer in women. The aim of this study was therefore to explore the lived experiences of women undergoing axillary lymph node dissection (ALND) due to BC.

Methods: Twelve women with a mean age of 59 years were interviewed about their lived experiences of axillary procedures as part of their BC treatment. The interviews were recorded, transcribed verbatim, and analysed using a phenomenological hermeneutical method. This narrative method enabled the researchers to reinterpret the worlds of the women with BC, as reflected in the data.

Results: The naïve understanding, ie, the meaning of the text as a whole, revealed that the participants were in a process of accepting and adapting to their life after ALND involving adjuvant chemotherapy and/or hormonal therapy. Thus, six main themes emerged in the thematic structural analysis illustrating the meaning of acceptance and adaptation when suffering from BC and undergoing a treatment trajectory, ie, establishing coherence, adjusting to treatment, safeguarding social belonging, re-defining oneself, feeling vulnerable, and accepting one's circumstances.

Conclusions: If healthcare professionals provided structure and consistency, the women's treatment and lived experiences made sense; the women experienced more certainty, freedom, and meaningful social interactions. Uncertainty occurred when the women became lost in their own sense-making process, leading to low self-efficacy. There is a need for a paradigm shift in surgical care from viewing women with BC as anatomical constructions in need of repair to deeply understanding that they are persons with an illness who require ongoing self-management support.