Body Image after Cancer
In thirty years of working with women with breast cancer, I don't think I have ever met anyone who felt more positively about her body after cancer than she had before. I have known a one or two women who claimed to prefer a reconstructed breast to the original, and I have known a few others who felt they looked better in their wig than with their natural hair. I have known a few more who appreciated a little weight loss from feeling crummy through treatment. Additionally, I have known many women who felt unhappy about a range of body changes (the most obvious being a mastectomy with or without reconstruction) and a general sense of distrust in their physical selves. Many, too, feel that the process aged them (certainly sudden menopause can do that, but it is a larger feeling than just stopping periods)
We adjust. We adapt. We learn that life is for living and we are grateful to be here to do so. That does not mean, however, that we don't sometimes grieve the physical losses as well as the existential ones that we have experienced.
Here is the abstract from a study in Sweden and Norway that examined body image in long-term breast cancer survivors. The most wonderful conclusion is that their views, at the end of the day, did not differ from those of women in the general population. Another testament to our strength and resilience!
A study of body image in long-term breast cancer survivors
Christian A. Falk Dahl, StudPsychol 1, Kristin V. Reinertsen, MD 2 3, Inger-Lise Nesvold, PT, MHSci 2 4, Sophie D. Fosså, MD, PhD 2
5, Alv A. Dahl, MD, PhD 2 5 *
1Department of Psychology, Uppsala University, Uppsala, Sweden
2Department of Clinical Cancer Research, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
3The Cancer Center, Ullevaal University Hospital, Oslo, Norway
4Department of Rehabilitation-Physiotherapy, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
5Faculty Division, The Norwegian Radium Hospital, University of Oslo, Oslo, Norway
email: Alv A. Dahl (firstname.lastname@example.org)
*Correspondence to Alv A. Dahl, Department of Clinical Cancer Research, The Norwegian Radium Hospital, Montebello, 0310 Oslo,
In this controlled postdiagnosis study, the authors examined various aspects of body image of breast cancer survivors in cross-
In 2004 and 2007 the Body Image Scale (BIS) was completed by the same 248 disease-free women who had been treated for stage II and III breast cancer between 1998 and 2002. Poorer body image was defined as greater than the 70th percentile (N = 76 women)
of the BIS scores in contrast to better body image (N = 172 women). Breast cancer survivors were examined clinically in 2004, and their BIS scores were compared with the scores from an age-matched group of women from the general population.
In this cross-sectional study, poorer body image in 2004 was associated significantly with modified radical mastectomy, undergoing or planning to undergo breast-reconstructive surgery, a change in clothing, poor physical and mental health, chronic fatigue, and reduced quality of life (QoL). In univariate analyses, most of these factors and manually planned radiotherapy were significant predictors of poorer body image in 2007. In multivariate analyses, manually planned radiotherapy, poor physical QoL and high BIS score in 2004 remained independent predictors of a poorer body image in 2007. Body image ratings were relatively stable from 2004 to 2007.
Twenty-one percent of breast cancer survivors reported body image dissatisfaction, similar to the proportion of dissatisfaction in controls.
In this cross-sectional analysis, body image in breast cancer survivors was associated with the types of surgery and radiotherapy and with mental distress, reduced health, and impaired QoL. Body image ratings were relatively stable over time, and the antecedent body
image score was a strong predictor of body image at follow-up. Body image in breast cancer survivors differed very little from that in controls
. Cancer 2010. © 2010 American Cancer Society.
Received: 8 October 2009; Revised: 23 December 2009; Accepted: 23 December 2009