Despite high survival, many breast cancer treatments have negative effects on a woman’s body, including loss of breast(s), tissue damage, deformities in the breast(s), decreased range of motion, lymphoedema, hair loss, weight gain, and muscle loss/weakness. These changes can have a profound impact on woman’s perception of physical attractiveness, femininity and overall body image.
The aim of this paper is to better understand predictors of poor body image in a group of overweight/obese breast cancer survivors.
Overweight and obese women diagnosed with breast cancer were recruited from an Australian State-based cancer registry to participate in a weight loss intervention trial. Independent associations of baseline demographic (age, marital status, waist circumference, weight change post-diagnosis), treatment-related (surgery type, lymphoedema, menopausal status) and psychosocial (depression [PROMIS; range 8-40; higher scores = greater impairment], fatigue [FACIT-Fatigue; range 0-52; higher scores = lower fatigue]) variables with body image (Body Image and Relationships Scale; range 32-160; higher scores = greater impairment) were tested using linear regression models.
Ninety women (mean±SD BMI: 31.0±4.3 kg/m2; aged 55.3±8.7 years; median 16 months post-diagnosis [range: 12-21 months]) were recruited. Mean body image score was 82.2±20.1. Higher levels of depression (0.75 [95% CI 0.05, 1.46]; p < 0.05) and fatigue (-0.92 [95% CI -1.33, -0.50]; p < 0.001) were the only statistically significant independent predictors of more impaired body image. Time since breast cancer diagnosis (in months) was of borderline significance (-1.23 [95% CI -2.49, 0.03]; p = 0.055).
Body image was more strongly associated with the psychosocial variables than treatment-related variables in this sample of overweight/obese survivors; however due to the cross-sectional nature of the data, it is difficult to establish the direction of these relationships. Understanding and addressing psychosocial issues related to body image should be an important component of breast cancer survivorship care.