Influence of Body Image in Women Undergoing Treatment for Breast Cancer

A quantitative, case-control study in which 90 women with breast cancer were evaluated in the case group, and 77 women without breast cancer in the control group. For data collection, the body satisfaction scale (BSS), a scale adapted and validated in Brazil, and the Rosenberg self-esteem questionnaire were used. For the statistical analysis of the data, the Statistical Package for the Social Sciences software (IBM-SPSS, Chicago, Il, US), version 16.0 was used.

Results

Compared with the women without breast cancer, those with breast cancer were more dissatisfied with body image related to appearance. Women undergoing neoadjuvant chemotherapy were more dissatisfied with their appearance compared with those with cancer who were not undergoing this treatment. Mastectomy also accounted for more dissatisfaction concerning appearance among women who underwent the procedure compared with the women who were submitted to breast-conserving therapy.

Conclusion

Women with breast cancer were more dissatisfied with their body image compared with those without breast cancer, particularly following mastectomy or during chemotherapy. The self-esteem was found to be negatively affected in patients who were dissatisfied with their body image.

Keywords
breast cancer; body image; self-esteem

Group	Case		Control		p	OR	95%CI
Group	n	%	n	%	p	OR	Lower	Upper
Age Group
31–40 years	12	13.3	19	24.7	0.07	0.38	0.14	1.05
41–50 years	34	37.8	23	29.9	0.80	0.89	0.36	2.17
51–59 years	24	26.7	23	29.9	0.33	0.63	0.25	1.58
≥ 60 years	20	22.2	12	15.6	0.170	0.81	0.59	1.10
	90	100.0	77	100.0
Marital status
Single	41	45.6	27	35.1
Married	49	54.4	50	64.9	0.170	1.55	0.83	2.90
Total	90	100.0	77	100.0
Level of schooling
Illiterate	7	7.8	3	3.9	0.22	3.27	0.51	24.84
Lower than high school	47	52.2	48	62.3	0.38	1.84	0.47	7.89
High school	32	35.6	20	26.0	0.23	2.37	0.58	10.58
Higher education	4	4.4	6	7.8	0.926	1.02	0.66	1.59
Total	90	100.0	77	100.0
Religion
Catholic	34	38.2	40	51.9	0.042	0.61	0.37	0.98
Evangelical	49	55.1	35	45.5	0.12	1.64	0.87	3.11
Spiritist	1	1.1	1	1.3	0.92	1.17	0.03	47.0
Others	5	5.6	1	1.3	0.10	5.77	0.75	143.2
Total	89	100.0	77	100.0
Occupation
Housewife	50	55.6	30	39.0	0.97	0.97	0.33	2.75
Nursing technician	3	3.3	2	2.6	0.90	0.88	0.11	9.00
Salesperson	6	6.7	3	3.9	0.88	1.16	0.21	7.29
Housemaid	5	5.6	11	14.3	0.07	0.28	0.06	1.12
Dressmaker	3	3.3	11	14.3	0.02	0.17	0.03	0.79
Receptionist	2	2.2	2	2.6	0.66	0.60	0.05	6.83
Retired	8	8.9	6	7.8	0.74	0.78	0.18	3.37
Teacher	1	1.1	5	6.5	0.07	0.13	0.00	1.14
Others	12	13.3	7	9.1	0.170	1.08	0.97	1.19
Total	90	100.0	77	100.0
Income
≤ 1 MW	39	45.9	25	33.3	0.195	1.74	0.75	4.01
1–2 MW	29	34.1	31	41.3	0.920	1.05	0.46	2.39
≥ 3 MW	17	20.0	19	25.3	0.145	1.35	0.90	2.03
Total	85	100.0	75	100.0
Origin
Capital city (Goiânia)	55	61.1	42	54.5	0.590	1.17	0.65	2.11
Cities in the interior of the state	33	36.7	35	45.5
Others States	2	2.2	0	0.0
Total	90	100.0	77	100.0

Group	Case (n= 90)			Control (n= 77)			p	Student's t-test
Group	Mean	Median	SD	Mean	Median	SD	p	Student's t-test
Body image – weight	23.98	23.50	6.84	23.10	23.00	7.57	0.435	0.783
Body image – appearance	56.71	56.00	17.58	66.75	71.00	19.02	0.001	−3.522
High self-esteem	12.24	13.00	2.21	12.73	14.00	2.73	0.209	−1.262
Low self-esteem	4.36	4.00	3.24	3.51	3.00	2.82	0.075	1. 789
Overall self-esteem	7.89	8.50	4.55	9.22	10.00	4.98	0.073	−1.805

Chemotherapy	Yes (n= 22)		No (n= 68)(Patients who underwent surgery)		p	Student's t-test
Chemotherapy	Mean	SD	Mean	SD	p	Student's t-test
Body image – weight	24.23	6.27	23.90	7.06	0.845	0.196
Body image – appearance	49.14	18.45	59.19	16.68	0.019	−2.390
High self-esteem	11.36	2.46	12.53	2.06	0.031	−2.197
Low self-esteem	4.55	3.61	4.29	3.14	0.754	0.314
Overall self-esteem	6.82	5.37	8.24	4.24	0.206	−1.275

Mastectomy	Yes (n= 23)		No (n= 67)		p	Student's t-test
Mastectomy	Mean	SD	Mean	SD	p	Student's t-test
Body image – weight	23.35	5.74	24.19	7.21	0.612	−0.509
Body image – appearance	46.00	14.02	60.22	17.28	0.001	−3.497
High self-esteem	12.17	2.15	12.27	2.25	0.860	−0.176
Low self-esteem	4.52	2.74	4.30	3.42	0.778	0.283
Overall self-esteem	7.65	3.54	7.97	4.87	0.774	−0.288
Breast conserving therapy	Yes (n= 21)		No (n= 69)		p	Student's t-test
Breast conserving therapy	Mean	SD	Mean	SD	p	Student's t-test
Body image - weight	22.71	7.87	24.36	6.52	0.337	−0.960
Body image - appearance	69.48	10.94	52.76	17.41	< 0.001	4.144
High self-esteem	12.86	2.33	12.06	2.15	0.148	1. 460
Low self-esteem	4.52	3.66	4.30	3.14	0.788	0.270
Overall self-esteem	8.33	5.32	7.75	4.32	0.612	0.509

Domains(n= 90)	Body image	High self-esteem	Low self-esteem	Overall self-esteem
Body image – weight
r	0.130	0.140	−0.218	0.223
p	0.223	0.188	0.039	0.034
Body image – appearance
r		0.367	−0.389	0.456
p		< 0.001	< 0.001	< 0.001
High self-esteem
r			−0.368	0.748
p			< 0.001	< 0.001
Low self-esteem
r				−0.892
p				< 0.001

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[1] Address for correspondence Ana Carolina Lagos Prates, MSc Programa de Mastologia, Hospital das Clínicas, Universidade Federal de Goiás (UFG) 1ª Avenida, s/n, Setor Leste Universitário, 74605-020 – Goiânia, Goiás Brasil lagosprates@gmail.com