MGHD 2024

Background: Cancer is a significant contributor to the global burden of non-communicable diseases. The International Agency for Research on Cancer (IARC) reported approximately 19.3 million new cases worldwide in 2020. In sub-Saharan Africa, over 800,000 new cancer cases were reported in 2020, of which breast cancer was the second leading after cervical cancer. The Butaro Cancer Center of Excellence (BCCOE) has been pivotal in providing comprehensive cancer care in Rwanda. However, there is limited research on the post-surgical experiences of Rwandan breast cancer patients following mastectomy. This study aims to explore these experiences, identify challenges, and understand coping mechanisms to enhance post mastectomy care and support. Methods: This qualitative, phenomenological study was conducted at BCCOE in Rwanda. The study employed in-depth interviews with adult female breast cancer patients attending post-surgical check-ups or receiving chemotherapy between April 30 and June 1, 2024. Participants were selected through simple random sampling from a patient database, ensuring inclusion criteria were met. Data collection involved semi-structured interviews using a guide developed from relevant literature, translated into Kinyarwanda for accuracy. Interviews were conducted in private settings, recorded with consent, and lasted 45-60 minutes. Transcripts were analyzed using thematic analysis and MAXQDA software was used to code and organize themes. The validity of the analysis was achieved through researcher triangulation. Data were stored securely, maintaining participants' anonymity and confidentiality. Ethical approval was obtained from the UGHE Institutional Review Board. Results: The study's findings are organized into seven thematic areas, illuminating the multifaceted challenges faced and coping mechanisms employed by post mastectomy cancer patients. Participants reported profound emotional distress concerning body image and self-perception. Many struggled to sustain their previous occupations due to physical limitations and encountered complexities in navigating healthcare and social dynamics. The impact extended to strained relationships with family and friends, highlighting significant interpersonal challenges. Coping strategies predominantly involved spiritual faith and seeking support from close relationships and community networks. The themes developed included 1. Emotional experience and body image and self-perception following mastectomy 2. Need for empathetic interaction and emotional support 3. Post mastectomy, individuals often face challenges continuing with their previous occupations 4. Navigating Healthcare and Social Dynamics 5. Mastectomy significantly impacts relationships with family and friends, often creating a strain that challenges the dynamics of family relationships and friendships 6. Coping with life after mastectomy 7. Support networks positively enhance the experiences of breast cancer patients after mastectomy and are essential in the recovery journey. Conclusion : The participants faced challenges including difficulties with follow-up visits due to long distances and high transport costs, and loss of previous occupations due to post mastectomy body changes. Stigma and misconceptions also emerged as pervasive issues. Therefore, there is a need for decentralized cancer care to facilitate local access to medication. Enhancing support programs to alleviate financial burdens, dismantle misconceptions around cancer, and establishing social support groups can emphasize the importance of comprehensive care strategies in improving the well-being of breast cancer patients after mastectomy.