On the pathway of changing emotions—a qualitative study of emotional changes in breast cancer patients from the first detection of the tumor to breast surgery

Abstract Background The trajectory of breast cancer is a dynamic experience, both physically and emotionally, and despite the same diagnosis, the emotional reactions to events during the healing process are quite individual. Therefore, to support the coping processes with the disease effectively in psychological practice with cancer patients, it is essential to explore the emotional reactions of patients and to gain insight into their emotion regulation processes. Our study aimed to explore different types of emotions that accompany the disease process and the impact of disease events on changes in the intensity of emotions. Methods We applied an exploratory, descriptive, phenomenological approach, and through purposive sampling, we involved 42 female participants (mean age 53.44, SD: 8.80) who had undergone breast surgery to conduct face-to-face semi-structured interviews based on Emotional Graph of Illness Trajectory, as a graphical elicitation technique. Interview data were analysed using content analysis involving two independent coders. Results 73.8% of the women with breast cancer reported one dominant emotion associated with their disease process, while 59.52% reported only negative emotions connected to their disease pathway. The most frequent negative emotion was fear, and the most frequent positive emotion was hopefulness. Our most outstanding results—such as the association of positive meanings linked to the course of the illness with positive emotions—suggested that patients' positive mental representation of the illness and healing process could have contributed to the adaptive emotion regulation. Conclusions Presumably, the development and change of the emotion associated with the disease process was determined by the patient's perception of the disease and the healing process, on the one hand, and the meaning attributed to the event, on the other hand. Our results highlight the importance of exploring the emotional aspects accompanying the disease process, as the emotional perspective provides insights into the emotional side of coping style during the disease process. The Emotional Graph of Illness Trajectory can help to restructure and re-evaluate the experience of illness and thus restore the disconnectedness of life history, which can lead to a psychological process that adaptively contributes to reducing the traumatic impact of disease. Trial registration ISRCTN, ISRCTN10290883. Registered 25 April 2024 – Retrospectively registered, https://www.isrctn.com/ISRCTN10290883