title: Concern about aspects of body image and adjustment to early stage breast cancer.
abstract: OBJECTIVE
  Several authors have suggested that patients adjust more poorly to breast cancer if they are heavily invested in body image as a source of their sense of self-worth. This prospective study examined this possibility, looking at two aspects of concern about body image as predictors of several indices of adjustment over the first postoperative year.
  
  
  METHODS
  At diagnosis (and again a year later) 66 women with early stage breast cancer reported how much they valued a) a sense of body integrity (or intactness) and b) a good physical appearance. The day before surgery, a week afterward, and at 3-month, 6-month, and 12-month follow ups, they reported on their mood. At presurgery and at follow ups they also rated their attractiveness and sexual desirability and reported on frequency of sexual interaction. At follow-ups they also indicated how much their illness and treatment were interfering with social and recreational activities.
  
  
  RESULTS
  Initial investment in appearance was related to distress across the postsurgical year. In contrast, investment in appearance made women more resilient against deterioration in their perceptions of attractiveness. Concern about body integrity did not strongly predict emotional distress, but it related to adverse impact on social and recreational activities in the follow-up period, to deterioration in feelings of sexual desirability, and to feelings of alienation from the self (feeling "not like yourself anymore").
  
  
  CONCLUSIONS
  Body image is often thought of in terms of physical appearance, but there is also a body image pertaining to integrity, wholeness, and normal functioning. People who are greatly concerned about either aspect of their body image are vulnerable to poorer psychosocial adjustment when confronting treatment for breast cancer. The poorer adjustment takes a different form, however, depending on the nature of the patient's body-image concern.
authors.affiliation: Department of Psychology, University of Miami, Coral Gables, Florida 33124-2070, USA. ccarver@umiami.ir.miami.edu
authors.forename: C S
authors.initials: CS
authors.lastname: Carver
authors.forename: C
authors.initials: C
authors.lastname: Pozo-Kaderman
authors.forename: A A
authors.initials: AA
authors.lastname: Price
authors.forename: V
authors.initials: V
authors.lastname: Noriega
authors.forename: S D
authors.initials: SD
authors.lastname: Harris
authors.forename: R P
authors.initials: RP
authors.lastname: Derhagopian
authors.forename: D S
authors.initials: DS
authors.lastname: Robinson
authors.forename: F L
authors.initials: FL
authors.lastname: Moffat
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D001828:Body Image; D001943:Breast Neoplasms / Q000523:psychology* / Q000628:therapy; D017281:Cost of Illness; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D012044:Regression Analysis; D012649:Self Concept; D012917:Social Adjustment