“… 31 In other words, the “expansion of self-awareness” in this study can be considered a state of PTG. Breast cancer survivors have been reported to experience PTG, 32 and the fact that PTG was also observed in patients with MBC is a new finding in this study. Therefore, it will be important for nurses to believe that patients with MBC has the ability to grow despite their predicament and to provide systematic and ongoing support from the time of MBC diagnosis onward to help patients use effective coping strategies to achieve an expanded sense of self.…”