Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-25T04:17:40.185Z Has data issue: false hasContentIssue false
  • English
  • Français

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 ,
Eun-Kyung Choi ,
Im-Ryung Kim ,
Seok Jin Nam ,
Jeong Eon Lee ,
Young-Hyuck Im ,
Jin Seok Ahn ,
Yeon Hee Park  and
Juhee Cho Open the ORCID record for Juhee Cho [Opens in a new window]
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: [email protected].
Get access Rights & Permissions [Opens in a new window]

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.

Keywords

Altered appearanceBody imageDistressBreast cancerSurvivorship
Type
Original Article
Information
Palliative & Supportive Care , Volume 16 , Issue 2 , April 2018 , pp. 137 - 145
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

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), 446–460.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), 590–597. Epub ahead of print Feb 7.Google 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), 1103–1110. Epub ahead of print Mar 24.Google Scholar
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), 1793–1798. 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), 167–176. Epub ahead of print Aug 5, 2010. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3265936/.Google Scholar
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), 311–320.Google Scholar
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), 3549–3557. 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), 579–594. Available from http://onlinelibrary.wiley.com/doi/10.1002/pon.991/pdf.Google Scholar
Gandhi, M., Oishi, K., Zubal, B., et al. (2010). Unanticipated toxicities from anticancer therapies: Survivors' perspectives. Supportive Care in Cancer, 18(11), 1461–1468. Epub ahead of print Dec 3, 2009.Google Scholar
Hsu, T., Ennis, M., Hood, N., et al. (2013). Quality of life in long-term breast cancer survivors. Journal of Clinical Oncology, 31(28), 3540–3548. Epub ahead of print Aug 26. Available from http://ascopubs.org/doi/full/10.1200/JCO.2012.48.1903.Google Scholar
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), 675–682. 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), 1383–1388. 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), 2879–2884. Epub ahead of print May 9. Available from https://academic.oup.com/annonc/article-lookup/doi/10.1093/annonc/mds095.Google Scholar
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), 101–108.Google Scholar
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), 317–328. Available from http://onlinelibrary.wiley.com/doi/10.1002/pon.1245/pdf.Google Scholar
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), 181–189. Epub ahead of print Jun 17, 2008.Google Scholar
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/.Google Scholar
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), 959–966.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), 2140–2147. 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), 883–885. Epub ahead of print Feb 16.Google Scholar
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), e53–e59.CrossRefGoogle Scholar
Stan, D., Loprinzi, C.L. & Ruddy, K.J. (2013). Breast cancer survivorship issues. Hematology/Oncology Clinics of North America, 27(4), 805–827. Epub ahead of print Jun 19. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3903408/.Google Scholar
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), 333–336. Epub ahead of print May 14.Google Scholar
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), 441–445. Epub ahead of print Apr 16.Google Scholar