What Japanese Women with Breast Cancer Decide: A Mixed Methods Analysis of Web-Based Open-Ended Responses

BACKGROUND: Living with breast cancer (BC) involves making many decisions, which immediately follow the diagnosis of BC. These decisions concern not only medical care, but also sociopsychological aspects, suggesting that women with BC need a wide range of support. To understand the challenges Japanese women encounter following a diagnosis of BC, we holistically explored decisions women perceived themselves to have made following such a diagnosis. METHODS: This was a cross-sectional, internet-based study comprising open-ended question. Qualitative content analysis was employed on the 1,158 free descriptive responses obtained from 549 participants. The frequencies of decisions were compared according to age at diagnosis using the chi-square test. RESULTS: Approximately 80% of the participants reported having made some decisions. These decisions were separated into 14 categories: two categories were related to medical care and 12 were related to sociopsychological decisions. The frequency of sociopsychological decisions was higher than that of medical care decisions. About two-thirds of participants reported having made more than two decisions, and about one-third reported having made both medical and sociopsychological decisions. The decisions made by women varied based on age group at diagnosis. The lower the age group at diagnosis, the higher was the frequency of decisions related to both medical care and sociopsychological matters. Participants who were diagnosed with BC at a younger age were more likely to encounter a greater number of sociopsychological decisions, such as those concerning employment, fatality, and marriage, compared with those who were diagnosed at an older age. CONCLUSIONS: This analysis of open-ended questions suggests that Japanese women diagnosed with BC have a wide range of support needs that vary according to their age group at diagnosis.