Palliative and Supportive Care

Original Articles

Challenges of illness in metastatic breast cancer: A low-income African American perspective

Margaret Quinn Rosenzweiga1 c1, Theresa Wiehagena1, Adam Brufskya2 and Robert Arnolda3

a1 University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania

a2 University of Pittsburgh Cancer Institute/Magee Women's Hospital, Pittsburgh, Pennsylvania

a3 University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania


Objective: Disparities in breast cancer survival and treatment for African American and low income women are well documented, yet poorly understood. As care for women with metastatic breast cancer (MBC) evolves to a chronic care model, any inequities in optimal treatment and management of symptoms must also be identified and eliminated. The purpose of this study was to explore how race and income status influence women's experiences with MBC, particularly the management of symptoms, by describing the perceived challenges and barriers to achieving optimal symptom management among women with MBC and exploring whether the perceived challenges and barriers differed according to race or income.

Method: Quantitative techniques were used to assess demographics, clinical characteristics, symptom distress, and quality of life and to classify women into groups according to race and income. Qualitative techniques were used to explore the perceived challenges, barriers, and potential influences of race and income on management of symptoms in a prospective sample of 48 women with MBC.

Results: Commonalities of themes across all groups were faith, hope, and progressive loss. Low-income African American women uniquely experienced greater physical and social distress and more uncertainty about treatment and treatment goals than the other delineated racial and economic groups.

Significance of results: There are many commonalities to the challenges of illness presented to women with MBC. There are also interesting, emerging thematic racial and economic differences, most compelling among the low income African American women with resultant practice and research implications.

(Received January 11 2007)

(Accepted January 26 2007)


c1 Address correspondence and reprint requests to: Margaret Quinn Rosenzweig, University of Pittsburgh School of Nursing, 3600 Victoria Building, Room 329-A, Pittsburgh, PA 15261. E-mail: