In the nearly two decades of cancer research in the United States. there has been little emphasis on the experiences of young adult women with breast cancer. I therefore adopted a qualitative multicase study method to explore the experiences of five young adult women from the time of discovery of a breast mass through the first three months of recovery from mastectomy. Utilizing data collected via semi-structured interviews. this study sought to describe their concerns, the way in which their

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... ncerns changed over time, and the influence of contextual factors. Three themes were identified. These included: "I'm going to die!" reassessing self. and seeking help from others. The findings identified areas for health care reform. These reforms include areas dealing with increasing the awareness of breast cancer in young adult women, facilitating early breast cancer detection. minimizing delays in treatment, and making adjustments in care such as improvements in education, early referral to the American Cancer Society. follow-up care, and the provision of individualized care to meet differing cultural needs. These "action areas" can be used to guide funding and the allocation of scarce resources for young adult women undergoing treatment for early breast cancer. Resource allocation is a topic of increasing importance in the latter part of this decade as the health care industry continues its pivotal shift from hospital centered care to managed care. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. DEDICATION This paper is dedicated to my children Ryan Joseph and Marissa Kathleen. Eleven years old, Ryan Joseph never knew anyone to rewrite papers more than once. He was concerned about the number of revisions required for this paper; yet, he never waivered in his support and encouragement of my great undertaking of doctoral studies! During this time, it was Marissa Kathleen who added joy to our lives as we celebrated her birth and marveled at her vast accomplishments during her first three years of life. ii Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. ACKNOWLEDGEMENTS