Changes in Body Image in Women with Early Stage Breast Cancer

Worldwide, breast cancer is the predominant form of malignancy in women (Hortobagyi et al., 2005). However, when diagnosed in an early stage, women have a good chance to survive for a longer period of time. Therefore, it is important to focus on the impact of breast cancer and its treatment on long-term psychosocial outcomes. In recent years, quality of life (QOL) has become a primary endpoint in oncology (Movsas, 2003, Sprangers, 2002). Body image is an important aspect of QOL, especially in breast cancer patients (Avis et al., 2005), because of the mutilating effect surgical treatment may have. Body image is a component of the self-concept of a woman, which includes feeling attractive and feminine (Fobair et al., 2006). Body image is defined in different ways, but typically conceived as a multidimensional construct, consisting of perceptual, attitudinal, and behavioral aspects.(Jolly et al., , Sarwer and Cash, 2008) Body image evaluation (e.g., satisfaction or dissatisfaction) and body image investment (i.e., the psychological importance of one’s appearance to his or her sense of self or self-worth) are the most central body image dimensions.(Sarwer and Cash, 2008) Patients experience a body image problem when a marked discrepancy exists between the actual or perceived appearance or function of a discrete bodily attribute(s) and an individual’s expressed ideal regarding this bodily attribute(s).(White, 2000) A positive body image is related to patients’ ability to cope with cancer (Pikler and Winterowd, 2003). In this study, the focus will be on the dimension of body image evaluation. Women with breast cancer often experience a decrease in satisfaction with body image after surgery, irrespective of type of surgical treatment (Brandberg et al., 2008, Ganz et al., 1992, Kraus, 1999, Lindop and Cannon, 2001). There is no consensus whether the type of surgery received is related to dissatisfaction with body image after surgery. Some studies found that women receiving MTC report lower scores on body image compared with women receiving BCT (Anagnostopoulos and Myrgianni, 2009, Engel et al., 2004, Ganz et al., 1992, Janni et al., 2001, Janz et al., 2005, Kenny et al., 2000, Schou et al., 2005). However, a number of studies did not find type of surgery to be a relevant factor in satisfaction with body image (Fobair et al., 2006, Goldberg et al., 1992, Schover et al., 1995, Wolberg et al., 1989). Furthermore, previous research was also inconsistent regarding adjuvant therapy. Although most studies