Skip to main content Accessibility help
×
Home
Hostname: page-component-55597f9d44-jzjqj Total loading time: 0.226 Render date: 2022-08-19T08:26:08.988Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "useRatesEcommerce": false, "useNewApi": true } hasContentIssue true

Distress and body image due to altered appearance in posttreatment and active treatment of breast cancer patients and in general population controls

Published online by Cambridge University Press:  06 March 2017

Danbee Kang
Affiliation:
Departments of Health Sciences and Technology and Clinical Research Design and Evaluation, Samsung Advanced Institute of Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea
Eun-Kyung Choi
Affiliation:
Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Im-Ryung Kim
Affiliation:
Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Seok Jin Nam
Affiliation:
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Jeong Eon Lee
Affiliation:
Departments of Health Sciences and Technology and Clinical Research Design and Evaluation, Samsung Advanced Institute of Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Young-Hyuck Im
Affiliation:
Department of Hematology and Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Jin Seok Ahn
Affiliation:
Department of Hematology and Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Yeon Hee Park
Affiliation:
Departments of Health, Behavior, and Society and Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Juhee Cho*
Affiliation:
Departments of Health Sciences and Technology and Clinical Research Design and Evaluation, Samsung Advanced Institute of Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Departments of Health, Behavior, and Society and Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
*
*Address correspondence and reprint requests to Juhee Cho, Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, 81 Irwon-ro, Gangnam, Seoul 06351, South Korea. E-mail: jcho@skku.edu.

Abstract

Objective:

Our objective was to evaluate long-term altered appearance, distress, and body image in posttreatment breast cancer patients and compare them with those of patients undergoing active treatment and with general population controls.

Method:

We conducted a cross-sectional survey between May and December of 2010. We studied 138 breast cancer patients undergoing active treatment and 128 posttreatment patients from 23 Korean hospitals and 315 age- and area-matched subjects drawn from the general population. Breast, hair, and skin changes, distress, and body image were assessed using visual analogue scales and the EORTC BR–23. Average levels of distress were compared across groups, and linear regression was utilized to identify the factors associated with body image.

Results:

Compared to active-treatment patients, posttreatment patients reported similar breast changes (6.6 vs. 6.2), hair loss (7.7 vs. 6.7), and skin changes (5.8 vs. 5.4), and both groups had significantly more severe changes than those of the general population controls (p < 0.01). For a similar level of altered appearance, however, breast cancer patients experienced significantly higher levels of distress than the general population. In multivariate analysis, patients with high altered appearance distress reported significantly poorer body image (–20.7, CI95% = –28.3 to –13.1) than patients with low distress.

Significance of results:

Posttreatment breast cancer patients experienced similar levels of altered appearance, distress, and body-image disturbance relative to patients undergoing active treatment but significantly higher distress and poorer body image than members of the general population. Healthcare professionals should acknowledge the possible long-term effects of altered appearance among breast cancer survivors and help them to manage the associated distress and psychological consequences.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Begovic-Juhant, A., Chmielewski, A., Iwuagwu, S., et al. (2012). Impact of body image on depression and quality of life among women with breast cancer. Journal of Psychosocial Oncology, 30(4), 446460.CrossRefGoogle ScholarPubMed
Brunault, P., Suzanne, I., Trzepidur-Edom, M., et al. (2012). Depression is associated with some patient-perceived cosmetic changes, but not with radiotherapy-induced late toxicity, in long-term breast cancer survivors. Psycho-Oncology, 22(3), 590597. Epub ahead of print Feb 7.CrossRefGoogle Scholar
Choi, E.K., Kim, I.R., Chang, O., et al. (2014). Impact of chemotherapy-induced alopecia distress on body image, psychosocial well-being, and depression in breast cancer patients. Psycho-Oncology, 23(10), 11031110. Epub ahead of print Mar 24.CrossRefGoogle ScholarPubMed
Cocks, K., King, M.T., Velikova, G., et al. (2008). Quality, interpretation and presentation of European Organisation for Research and Treatment of Cancer quality of life questionnaire core 30 data in randomised controlled trials. European Journal of Cancer, 44(13), 17931798. Epub ahead of print Jul 1.CrossRefGoogle ScholarPubMed
Collins, K.K., Liu, Y., Schootman, M., et al. (2011). Effects of breast cancer surgery and surgical side effects on body image over time. Breast Cancer Research and Treatment, 126(1), 167176. Epub ahead of print Aug 5, 2010. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3265936/.CrossRefGoogle ScholarPubMed
de Boer, A.G., van Lanschot, J.J., Stalmeier, P.F., et al. (2004). Is a single-item visual analogue scale as valid, reliable and responsive as multi-item scales in measuring quality of life? Quality of Life Research, 13(2), 311320.CrossRefGoogle ScholarPubMed
Falk Dahl, C.A., Reinertsen, K.V., Nesvold, I.L., et al. (2010). A study of body image in long-term breast cancer survivors. Cancer, 116(15), 35493557. Available from http://onlinelibrary.wiley.com/doi/10.1002/cncr.25251/full.CrossRefGoogle ScholarPubMed
Fayers, P.M., Aaronson, N.K., Bjordal, K., et al. (2001). The EORTC QLQ–C30 Scoring Manual, 3rd ed. Brussels: European Organisation for Research and Treatment of Cancer. Available from http://www.eortc.be/qol/files/SCManualQLQ-C30.pdf.Google Scholar
Fobair, P., Stewart, S.L., Chang, S., et al. (2006). Body image and sexual problems in young women with breast cancer. Psycho-Oncology, 15(7), 579594. Available from http://onlinelibrary.wiley.com/doi/10.1002/pon.991/pdf.CrossRefGoogle ScholarPubMed
Gandhi, M., Oishi, K., Zubal, B., et al. (2010). Unanticipated toxicities from anticancer therapies: Survivors' perspectives. Supportive Care in Cancer, 18(11), 14611468. Epub ahead of print Dec 3, 2009.CrossRefGoogle ScholarPubMed
Hsu, T., Ennis, M., Hood, N., et al. (2013). Quality of life in long-term breast cancer survivors. Journal of Clinical Oncology, 31(28), 35403548. Epub ahead of print Aug 26. Available from http://ascopubs.org/doi/full/10.1200/JCO.2012.48.1903.CrossRefGoogle ScholarPubMed
Kang, D., Kim, I.R., Im, Y.H., et al. (2015). Quantitative changes in skin composition parameters due to chemotherapy in breast cancer patients: A cohort study. Breast Cancer Research and Treatment, 152(3), 675682. Epub ahead of print Jul 22.CrossRefGoogle ScholarPubMed
Kim, I.R., Cho, J.H., Choi, E.K., et al. (2012). Perception, attitudes, preparedness and experience of chemotherapy-induced alopecia among breast cancer patients: A qualitative study. Asian Pacific Journal of Cancer Prevention, 13(4), 13831388. Available from http://journal.waocp.org/article_26344_82685fe852be892c6b519b9773249735.pdf.CrossRefGoogle ScholarPubMed
Kluger, N., Jacot, W., Frouin, E., et al. (2012). Permanent scalp alopecia related to breast cancer chemotherapy by sequential fluorouracil/epirubicin/cyclophosphamide (FEC) and docetaxel: A prospective study of 20 patients. Annals of Oncology, 23(11), 28792884. Epub ahead of print May 9. Available from https://academic.oup.com/annonc/article-lookup/doi/10.1093/annonc/mds095.CrossRefGoogle ScholarPubMed
Lee, E.S., Lee, M.K., Kim, S.H., et al. (2011). Health-related quality of life in survivors with breast cancer 1 year after diagnosis compared with the general population. Annals of Surgery, 253(1), 101108.CrossRefGoogle ScholarPubMed
Lemieux, J., Maunsell, E. & Provencher, L. (2008). Chemotherapy-induced alopecia and effects on quality of life among women with breast cancer: A literature review. Psycho-Oncology, 17(4), 317328. Available from http://onlinelibrary.wiley.com/doi/10.1002/pon.1245/pdf.CrossRefGoogle ScholarPubMed
Mols, F., van den Hurk, C.J., Vingerhoets, A.J., et al. (2009). Scalp cooling to prevent chemotherapy-induced hair loss: Practical and clinical considerations. Supportive Care in Cancer, 17(2), 181189. Epub ahead of print Jun 17, 2008.CrossRefGoogle ScholarPubMed
Montazeri, A., Vahdaninia, M., Harirchi, I., et al. (2008). Quality of life in patients with breast cancer before and after diagnosis: An eighteen months follow-up study. BMC Cancer, 8, 330. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2588619/.CrossRefGoogle ScholarPubMed
Moreira, H., Silva, S. & Canavarro, M.C. (2010). The role of appearance investment in the adjustment of women with breast cancer. Psycho-Oncology, 19(9), 959966.CrossRefGoogle ScholarPubMed
National Cancer Institute (1999). Common Toxicity Criteria, Version 2.0. Rockville, MD: The National Cancer Institute. Available from http://www.fda.gov/ohrms/dockets/dailys/04/mar04/033104/78n-0036L-rc00002-04-Tab-C-vol137.pdf.Google Scholar
Nozawa, K., Shimizu, C., Kakimoto, M., et al. (2013). Quantitative assessment of appearance changes and related distress in cancer patients. Psycho-Oncology, 22(9), 21402147. Epub ahead of print Feb 25.CrossRefGoogle ScholarPubMed
Prevezas, C., Matard, B., Pinquier, L., et al. (2009). Irreversible and severe alopecia following docetaxel or paclitaxel cytotoxic therapy for breast cancer. The British Journal of Dermatology, 160(4), 883885. Epub ahead of print Feb 16.CrossRefGoogle ScholarPubMed
Ra, H.S., Shin, S.J., Kim, J.H., et al. (2013). The impact of dermatological toxicities of anti-cancer therapy on the dermatological quality of life of cancer patients. Journal of the European Academy of Dermatology and Venereology, 27(1), e53e59.CrossRefGoogle ScholarPubMed
Stan, D., Loprinzi, C.L. & Ruddy, K.J. (2013). Breast cancer survivorship issues. Hematology/Oncology Clinics of North America, 27(4), 805827. Epub ahead of print Jun 19. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3903408/.CrossRefGoogle ScholarPubMed
Tallon, B., Blanchard, E. & Goldberg, L.J. (2010). Permanent chemotherapy-induced alopecia: Case report and review of the literature. Journal of the American Academy of Dermatology, 63(2), 333336. Epub ahead of print May 14.CrossRefGoogle ScholarPubMed
Yun, Y.H., Bae, S.H., Kang, I.O., et al. (2004). Cross-cultural application of the Korean version of the European Organisation for Research and Treatment of Cancer (EORTC) Breast-Cancer-Specific Quality of Life Questionnaire (EORTC QLQ–BR23). Supportive Care in Cancer, 12(6), 441445. Epub ahead of print Apr 16.Google Scholar
12
Cited by

Save article to Kindle

To save this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Distress and body image due to altered appearance in posttreatment and active treatment of breast cancer patients and in general population controls
Available formats
×

Save article to Dropbox

To save this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about saving content to Dropbox.

Distress and body image due to altered appearance in posttreatment and active treatment of breast cancer patients and in general population controls
Available formats
×

Save article to Google Drive

To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about saving content to Google Drive.

Distress and body image due to altered appearance in posttreatment and active treatment of breast cancer patients and in general population controls
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *