Breast Cancer Disclosure in Iranian Families: A Qualitative Study of Family Roles and Women’s Agency in Managing Disclosure

Background and Aim: Illness disclosure is a critical issue following a breast cancer diagnosis. Family members are often the first to be informed and play a central role in treatment decisions and the dissemination of information. In family-centered cultures, interactions between women and their families profoundly shape the disclosure process. Breast cancer disclosure should thus be understood not merely as an individual act but as a social and communicative process embedded within familial and cultural values. Methods This qualitative study involved in-depth, semi-structured interviews with 25 women with breast cancer in Tehran who had completed treatment, alongside five family caregivers. Participants were recruited using purposive and snowball sampling. Interviews explored family roles and interactions in managing disclosure. Data were analyzed using Braun and Clarke’s thematic analysis approach. Results Five themes emerged: (1) family values and interactional norms in disclosure, (2) the collective family image and its influence on disclosure, (3) emotional experiences of disclosure within the family, (4) women’s agency and breaking through disclosure constraints, and (5) identity formation through expressing breast cancer experiences. Disclosure decisions were guided by cultural and familial values, often constrained to protect the family’s social reputation. Emotional responses ranged from positive to negative. Women exercised agency, with some openly sharing their condition, including via social media. Positive expression and emphasis on personal growth emerged as key strategies for reconstructing identity post-diagnosis. Conclusion Breast cancer disclosure unfolds through dynamic interactions between women and their families, mediated by social norms and cultural taboos. While some women use disclosure to challenge societal perceptions, public awareness initiatives may facilitate disclosure and improve access to care.