How Breast Cancer Can Affect Your Body Image

breast cancer surgery scar
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Breasts have been a symbol of femininity and sexuality since civilization began, so it is not unusual for a breast cancer patient to feel that the disease has attacked her body image along with her breast tissue.

"Yes, I feel like people are staring. And it's hard to find clothes. And, yes, I get frustrated a lot," one woman wrote on the National Breast Cancer Foundation Survivor online forum. "But...I had to learn to love my body again."

Whether a cancer patient preserved her breasts, removed them, or reconstructed them, learning to accept and even love a post-diagnosis body is a process. Be sure to include family, friends, and especially partners in this aspect of cancer treatment.

Also, never be afraid to talk about body image issues with a physician. Studies show us that physicians often fail to bring up this important subject. Be your own advocate for your cancer care and speak up—you are worth it!

Breast Cancer and Body Image

Breast cancer does not just lead to mastectomy scars alone. Radiation can lead to redness and soreness in the affected area, chemotherapy often causes hair loss and weight gain, and the inner scars on your emotions can be just as challenging. 

Experiencing these types of body changes can be especially challenging for younger women, as research has shown that these women tend to be bothered more by these changes than women over 67.

It can be difficult to express the sense that your body has betrayed you or that the loss of one or both of your breasts can feel like an end to being female. 

Some women find that they begin to avoid intimacy, dress alone or in the dark, or even limit bathing as they cope with the effects of breast cancer.

These behaviors are common but should lessen and improve with time. If you or a loved one needs help coping with body image issues, talk to a physician, support group, or trusted counselor.

Surgical Options and Body Image

Women can become self-conscious about their breasts simply because breast cancer impacts an intimate part of the body. In many cases, though, it is not cancer that causes the emotional scars related to breast cancer, it is the treatment.

At the time of diagnosis, most women are faced with three possible surgical options:

  1. Lumpectomy—the removal of the cancerous tissue and a small amount of normal tissue around the lump.
  2. Partial mastectomy—the removal of the cancerous tissue and a larger amount of the remainder of the breast than what's taken in the lumpectomy procedure. (A partial mastectomy usually involves a quadrant or two of the breast.)
  3. Mastectomy—the removal of one or both breasts.

There is no definitive study on how these surgical treatments affect self-esteem and body image. When considering surgical choices, each woman needs to think about her type of cancer, the physician's recommendations, family history, the risk of recurrence, and, of course, any anticipated body image issues.

Be sure to ask questions and conduct research on each option. Do not be afraid to ask other breast cancer survivors, whether online or through a support group, how the surgeries affected their self-esteem. Make sure to talk to several people, as each woman's experience may be colored by her own expectations and background.

Lumpectomy, Mastectomy, and Reconstruction

Though a lumpectomy or partial mastectomy does preserve the breast, some women who choose these procedures will see what plastic surgeons call "distortions" in the appearance of the breast. These distortions can include scarring or significant changes in breast size.

According to one study, though, severe distortions are uncommon.

Some women will choose to use a prosthesis, which fits inside a bra, to fill out clothes and avoid questions. Other women may opt for reconstructive surgery. Reconstruction surgery can be done at the time of your breast cancer surgery or later on when you have healed. 

Women apparently adjust better with immediate reconstruction, but this is not always possible. There are several medical reasons for a delayed reconstruction, but one scenario women sometimes face is the difficulty with lining up both a surgeon and plastic surgeon to be in the same place at the same time and under their insurance coverage.

If you are struggling with this issue, reach out to the many support services available for women with breast cancer so you don't have to go this alone. It is possible but can take some work.

There are countless medical studies which speak of the psychological benefits of reconstructive surgery. Some studies report that women who chose reconstructive surgery experience a healthier body image than women who do not; however, other studies indicate that women who select reconstructive surgery have higher anxiety about breast loss than women who do not choose to undergo this surgery.

It's also important to have realistic expectations regarding the breast reconstruction. Some women are disappointed when their reconstructed breasts do not look like their original breasts, while others view it as a chance to have the breast size they have always wanted (a kind of silver lining).

It's important to remember that breast reconstruction does not restore sensation to the breasts. And open communication with your partner is very important if you choose this route.

Tips for Maintaining a Positive Body Image

Just as with any psychological issue, women with breast cancer can benefit from engaging in an honest conversation about their cancer-related body image issues. In addition to just "getting it out there," women can do several things to take charge of improving their self-esteem. Eating a healthy diet and taking time to exercise not only help with body image but may lower the risk of recurrence.

Be loving and supportive in regard to a woman's changing body image–a partner's support can go a long way. Expressing acceptance and encouragement as a woman makes changes in her wardrobe, hairstyle, or even lifestyle can make the transition from a pre-cancer to a post-cancer body a little easier.

One study found that sex therapy and couples counseling improved self-esteem among women with cancer. Keep in mind that good communication helps in rebuilding intimacy and may take patience, persistence, and a little creativity.

Dr. Helen Coons, a psychologist who specializes in women's health and mental health, recommends breast cancer survivors strengthen their self-image by exercising regularly, getting treated for depression, improving communication, relearning how to be intimate, and giving themselves a treat, such as a manicure or a new bra.

Dr. Coons encourages women to become active, as exercise can reduce depression and improve overall self-esteem. In addition, she says several of her patients have seen drastic self-image improvements by asking their plastic surgeon to improve the appearance of their incision site. 

Sources:

American Cancer Society. New choices in breast cancer surgery and reconstruction. 10/20/15. 

Fazzino, T., Hunter, R., Sporn, N., Christifano, D., and C. Befort. Weight fluctuation during adulthood and weight gain since breast cancer diagnosis predict multiple dimensions of body image amount rural breast cancer survivors. Psychooncology. 2015 Nov 12.

Fobair, P., Stewart, S., Chang, S., D’Onofrio, E., Banks, P., and J. Bloom. Body image and sexual problems in young women with breast cancer. Psychooncology. 2006. 15(7):579-94.

Male, D., Fergus, K., and K. Cullen. Sexual identity after breast cancer: sexuality, body image, and relationship repercussions. Current Opinion in Supportive and Palliative Care. 2016. 10(1):66-74.

Teo, I., Reece, G., Christie, I. et al. Body image and quality of life of breast cancer patients: influence of timing and stage of breast reconstruction. Psychooncology. 2015 Sep 10.

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