A diagnosis of breast cancer can create anxiety in even the calmest person, but younger women seem to find such a diagnosis particularly difficult. Studies have consistently shown that younger women report greater psychological distress following breast-cancer diagnosis than do older women.

Researchers have been looking at the relationship between the coping strategies of women with breast cancer and their quality of life (QOL). A study published in the Journal of Behavioral Medicine, for example, which concentrated on younger women with breast cancer, suggests that a person's QOL often determines the coping strategies she will use.

Several investigations have also found that younger women with breast cancer report a significantly lower QOL than do older women, particularly in the emotional and social domains. This makes sense when you look at the unique issues facing younger women:

• the premature onset of menopause, which may lead to 
  • infertility
  • the sudden onset of vasomotor symptoms (hot flashes and/or night sweats)
  • the long-term consequences of ovarian decline
• changes in their relationships with their partners and children
• demands of multiple role of parenthood and career
• greater concerns about body image and sexuality

Add to all this the fact that, if a younger woman survives the disease, she has a longer time to live with concerns about recurrence and about the long-term side effects (like bone loss) that may await her.

The study also revealed that younger women changed their coping strategies over time. Thus, as they grew older they became more detached and let go of some of the wishful thinking and social neediness that seems to preoccupy younger women.

Positive cognitive restructuring—that is, reinterpreting or reframing something stressful as a positive or helpful experience—was the most frequently used coping strategy and its use remained high over time. Keeping feelings to oneself was the least used coping strategy and its use remained consistently low over time.

Having myself been diagnosed the first time in my 30s and the second time at age 40, I can certainly relate to all of this. So tell me, how about you or someone you know?