The 'cues' to diagnosis: describing the monitoring activities of women undergoing diagnostic investigations for breast disease.

Waiting to ascertain the nature of an undiagnosed breast abnormality is an intensely stressful experience for many women. Uncertainty surrounding the aetiology of symptoms is underpinned by the threat of malignancy, and the 'need to know' the diagnosis is of primary concern at this time. Seeking out threat-relevant information through a process known as 'monitoring' attempts to fulfil this need. This paper details the qualitative phase of a multimethod research study that investigated the psychological impact of diagnosing breast disease. This involved focus interviews with a subset of 40 women from the original study cohort. Several types of threat-related cues were identified by respondents and were categorized as temporal, interpersonal, procedural and spatial. In the context of uncertainty (and in some cases suspicion) these cues were interpreted as 'indicators' of the pending diagnosis. The manner in which particular aspects of the environment are identified, interpreted and designated as 'threat-relevant' cues is discussed. Furthermore, the implications for health professionals working with patients during this stage of 'pre-diagnosis' are considered.