Hide and Seek: Body Image- Related Issues for Breast Cancer Survivors with Lymphedema

Although previous studies of breast cancer survivors with lymphedema have examined body image, none have examined body image as a multidimensional experience within this population. The purpose of this paper is to present focus group findings related to body image in breast cancer survivors with lymphedema. Focus groups were conducted at Vanderbilt University School of Nursing and were audio recorded and transcribed verbatim. Transcripts were coded line-by-line using ATLAS.ti software by three independent reviewers. Initial coding was clustered into categories representing broader categories of similar codes. A fourth non-biased outside consultant independently reviewed transcripts and codes. Identified themes included stigma-related concerns, and narrowed options for self-presentation. Stigma related concerns included the subthemes of uneasiness in public and avoidance, hiding both swollen parts of their body, and at times, themselves from public view. Narrowed options for selfpresentation included the subthemes of limited clothing options and frustration about undesired changes in dress. Hours were spent seeking acceptable apparel. The pattern of hide and seek as a strategy to deal with body image issues has been identified as problematic. Practical assistance in locating resources and psychological support are both indicated.