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Body Image Concerns

Reviewed by: Anne Katz, RN, PhD

Updated October 10, 2012

Breast cancer and its treatment may change how you feel about your body. You may be coping with scars, pain, weight gain or loss, hair loss or thinning, sexual side effects,  changes in sensation,and lymphedema.

These changes may be immediate or gradual, temporary or permanent. Add them to the physical and emotional impacts of treatment, and however you thought about your physical self—your body image—before your diagnosis, you may now see yourself differently. Every woman’s experience varies, and:

  • Physical changes might bother you, a little or a lot
  • You may be adapting or looking for solutions
  • You might feel diminished physically, or that you’re living in a body you don’t recognize as your own
  • You may consider the changes to be signs of your strength in the face of serious illness

These are normal and very common reactions, but there are things you can do, now and in the future, to feel better about your body. Your body image is important because it can influence your emotions, relationships, sexual activity and overall health.

My Body, My Self

Your thoughts about your physical appearance and your beliefs about how others see you contribute to your body image. Many women grapple with body image, even if they never have breast cancer. 

How much breast cancer affects your body image may be influenced by:

  • Your age at diagnosis
    • Youngwomen often expect to have healthy bodies
  • The importance you put on personal appearance
  • How you felt about your body (athletic, unattractive, sexy, etc.) before diagnosis
  • If you ever experienced sexual abuse or serious illness

Whether treatment ends or is ongoing, body image worries related to breast cancer may persist. But it is possible to improve how you see yourself.

Body Image Challenges After Treatment

Women diagnosed with breast cancer often report these body image concerns: 

  • Feeling as if your body has been violated or let you down, or you lost control of it
    • Scars are a constant reminder of cancer
    • Not feeling “whole” anymore
    • Lymphedema can develop, no matter how careful you are
  • Losing signs of what makes you feel like a woman
    • Losing the hair on your head, eyelashes, eyebrows and pubic area can be distressing
    • Removing part of or all your breasts may hurt your sense of femininity
      • Breasts remain strongly associated with womanhood, fertility and sexiness
      • Affects source of sexual pleasure, if you enjoy breast play
      • If you want to have children, the changes might prevent breastfeeding
      • After treatment, your partner might avoid touching your breast area for fear of hurting or upsetting you, reinforcing a negative body image
  • Unexpected results of treatment
    • Your breasts may look uneven after lumpectomy
    • Reduced range of motion in your arm
    • Skin changes from radiation
    • Your reconstructed breast might not look like the original and may not feel like your own, natural breast
  • Changes in sensation
    • Surgical scars may feel numb or painful
    • You may lose sensitivity in your breast or nipple
    • Neuropathy (nerve tingling or numbness) or pain may develop
  • Menopausal symptoms
    • Hot flashes, night sweats and fatigue may heighten feelings of being trapped in someone else’s body
    • Vaginal dryness, changes in sexual desire, or both may occur
      • When you feel no desire for or avoid sex because of pain, it may affect your body image
  • Weight changes
    • Can be weight gain or loss, but it is often gain
    • If you have trouble taking off the weight, it can make you feel less comfortable with your body

Ways to Strengthen Body Image

Doing something every day to take care of yourself can sustain or build your body image. Start with small changes, and congratulate yourself for every small step you take. Helpful self-care steps include:

  • Choose healthier foods
    • Good nutrition improves your spirits and stamina
    • Limit or stop drinking alcohol
  • Be physically active
    • Helps build your confidence, sense of control, strength and fitness
    • Can help with weight control
    • Walking for errands or exercise, dancing in a fun class or riding a bike can improve how you feel about your body
    • Do what you like—that’s the best exercise for you!
  • Try makeup or clothing changes that feel good to you
    • After breast surgery, a lingerie shop with certified fitters can help you find bras,breast forms or prostheses. Your health insurance may pay for some of these
    • Find nightclothes that are comfortable against your skin or make you feel sexy
    • If you like wearing makeup, choose new colors or types
    • Adapt to hair loss in the way that feels right to you. Wear a beautiful headcovering, go bald or wear earrings you love
  • Give yourself a break!
    • When your thoughts become critical of your body, shut them off
      • The more often you stop negative thoughts, the easier it gets
      • Try saying a mantra to stop the thoughts
      • Reduceyour stress by limiting the number of duties or commitments you take on
      • Do breast reconstruction only because you want it, not for others
        • Take the time you need to think about the decision
        • You can delay reconstruction without affecting your treatment
  • Rest
    • Learn more about fatigue and steps you can take to manage it
    • Help restore your body and spirits with regular rest
    • If you’re worried about sleeping too much, talk with your doctor
  • Get help for sexual difficulties
    • Restoring your sexual self can improve body image
    • There are solutions for sexual concerns related to breast cancer treatment
    • Try sensual massage to regain the enjoyment of being touched
  • Talk with your partner, if you have one
    • Speak about your body image worries
    • Discuss where and how you like being touched now
    • Share your concerns about your partner’s reactions to your body
    • Focus on strengthening intimacy, your emotional connectedness with each other
    • For help with this conversation, talk with an oncology social worker, psychologist or counselor

This article was supported by Cooperative Agreement Number DP11-1111 from The Centers for Disease Control and Prevention.Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention. 

Denver, CO  ·  September 13, 2014

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