Factors predicting communication about the diagnosis of maternal breast cancer to children

Objective: To identify factors influencing mothers' communication with their children about their diagnosis and initial treatment. Design: Cross-sectional cohort. Setting: Two breast cancer treatment centres. Subjects: Thirty-two women with Stage I or Stage 11 breast cancer with 56 school-aged children. Main outcome measures: Semistructured interview regarding timing and extent of communication with children from the time that a problem was first identified to initial treatment, and children's reactions. Results: Children were most likely to be told about their mother's illness after the diagnosis had been confirmed by biopsy but a minority were told nothing until after surgery and some nothing at all. The information children received did not necessarily include mention of cancer. Predictors of communication were child age, with older children being told earlier and more information, and maternal education, with children of more highly educated mothers being told less. Child gender was not related to communication. Conclusion: Mothers who are being investigated for breast cancer are likely to benefit from the opportunity to consult a supportive professional about communication with their children during all stages of their diagnosis and treatment, but particularly early on in the investigation when they are more reluctant to initiate discussions with their children. At later points, those with children of varying ages may need specific advice on ways to discuss their illness in relation to children's understanding. (C) 2002 Elsevier Science Inc. All rights reserved.