Breast cancer and your body image

Breast cancer and its treatment may change how you feel about your body. Scars, pain, weight gain or loss, hair loss or thinning, sexual side effects, changes in sensation, or lymphedema can trigger feelings of surprise and sadness, even if you were prepared for side effects.

Most women say their first priority after diagnosis is treating the cancer. You might feel rushed into making decisions about surgery, and then be unhappy with how you feel and look afterward.

Other side effects, including hot flashes from early menopause or fatigue that prevents you from being as active as you were before breast cancer, can leave you feeling less confident or in control.

Your unique response to body changes

Everyone responds differently to the physical changes of breast cancer. Some factors that influence your response are:

  • Your age
  • How you define femininity for yourself
  • What breasts, hair, and other physical features mean to you
  • How you felt about your body before diagnosis
  • A personal history of sexual abuse or serious illness

Your past experiences, personality and your support system also play a role.

Scarring

Radiation can cause thinning skin and color changes, and surgery can leave permanent scars. Some women find it helpful to look at pictures of those who had breast cancer surgery or radiation in the past for clues about what their bodies and scars could look like afterward.

A scar is a visible reminder of what you have been through. Some women say they’re afraid to look at the scars on or around the breast area after lumpectomy or mastectomy, or to show those scars to current or possible future sexual partners.

Scars won’t always look as big and scary as they do right after treatment. Thankfully, what looks like a big red line or patch at first often gets less visible over time.

As you heal from breast cancer surgery, look at your body and feel the scars. You don’t have to do this all at once or right away. The more you look and touch your changed body, the more comfortable you can become with the changes. If you have a sexual partner, it also helps to let them see and touch your scars.

Learn more about skin care and scarring after breast cancer treatment. 

Weight gain or loss

After breast cancer treatment, your body may look different or even have a different shape. This is not just the result of breast cancer surgery but can happen because of weight gain or loss caused by treatment.

For many women, weight gain is one of the hardest side effects. We don’t know exactly why, but about half of women undergoing breast cancer treatment gain weight. Often this is a few pounds, but some women gain more. If you were trying to gain weight or build muscle before your diagnosis, losing that weight and muscle can be hard. Even if you are an athlete, the changes to your schedule for treatment may have kept you from exercising as you once did. That can result in lost muscle definition or lost weight.

There are ways to work out safely while in treatment, even if it’s not as you did before. Meet with a personal trainer with experience working with people with cancer, and get advice from your doctors. Give yourself time and start exercise gradually. Research shows that a healthy diet with lots of fruits and vegetables and getting regular exercise can keep you healthy. And when your body is strong and healthy, you feel better about yourself.

Hair loss and skin changes

Most people know chemotherapy can cause hair loss on your head, but what surprises many women most is the loss of hair all over their bodies: eyelashes, eyebrows, pubic hair.

Chemotherapy can also cause dry, flaky skin. Radiation may change the color of the skin or give you a sunburn-like look.

If your hair and skin were important to your sense of self before cancer, such changes are a shock. Hair is tied to many women’s sense of beauty and attractiveness. Children can react strongly to hair loss, which adds to distress.

Hair loss reminds some people of the loss of their good health. Others say they hate losing control over their appearance. And still others don’t mind losing arm, leg, or pubic hair, and say the temporary hair loss is a welcome break from shaving and waxing.

For the most part, hair loss and skin changes are temporary. Your hair will grow back after treatment and your skin will return to its normal color. It’s possible the hair on their head will grows back with a different texture than before: straight hair might grow back curly.

Loss of femininity

For some women being feminine means having beautiful hair and a curvy figure. It can also be related to a satisfying sex life. But vaginal dryness and other menopausal symptoms might now make sex uncomfortable.  

Feeling less feminine because you’ve lost a breast or because it’s harder for you to enjoy sex are aspects of negative body image. You have your own feelings, and so will intimate partners involved in your life.

There are many ways to feel empowered and strong, including wearing clothes that make you feel confident and sexy, and doing activities that make you feel good. You are more than your breasts; you are more than your body.

Loss of self-confidence

All the physical changes of breast cancer can make you feel less sure of yourself.

Members of our community say they sometimes feel others think negative thoughts about them, feel sorry for them, or believe they’re too sick to take part in life. And those whom they trust most can say hurtful things about how they look, whether intended or not.

If loss of confidence makes you feel bad about other aspects of your life, talk with a professional counselor or with others who share your experiences.

Comfort with sex

Breast cancer treatments — and the fatigue, discomfort, and pain that sometimes accompany them — may weaken your sex drive or make sex uncomfortable. Stress can have the same effect.

Some women with a breast cancer history report lower sexual desire, lower ability to reach orgasm, more sex-related pain, and less frequent sex than women who have not had breast cancer.

Even if the desire is there, you might feel uncomfortable about the changes to your body. It’s common to worry how your partner will respond to your body now.

For women whose breasts are part of arousal or for whom breast play was a trigger for orgasm, the loss of a breast or breasts can have a significant and distressing impact on your sexual response and satisfaction.

Be open and honest with your partner about what you’re feeling, and encourage your partner to do the same. Seeking advice from a couples counselor or sex therapist may also help.

Sex and intimacy are different things. Holding hands, hugging, and just spending time with your partner can maintain your intimacy, even if you aren’t having sex.

For single people, it can be nerve wracking to tell potential new partners about your breast cancer history. Take new relationships slowly. When thinking about telling a date about your diagnosis, practice what you’re going to say in a mirror first. Don’t be shy about ending the relationship if the person can’t handle it. Read more about sex and intimacy after a breast cancer diagnosis. 

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Updated 
August 31, 2015
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