title: Factors Influencing Body Image in Women with Breast Cancer: A Comprehensive Literature Review.
abstract: BACKGROUND
  Many psycho-socioeconomic and other types factors associated with cancer, the treatment process, and changes in patients' physical appearance and sexual function influence the body image of women with breast cancer. The purpose of this study was to determine which factors influence the body image of women with breast cancer.
  
  
  METHODS
  A narrative literature review was conducted. Electronic databases, including Google Scholar, SID, Magiran, IranDoc, Barekat, Web of Science, Science Direct, Cochrane Library, ProQuest, Scopus, and PubMed, including Medline, were searched to retrieve articles published from 1993 to 2016 using the keywords breast cancer, treatment, body image, and related factors. The quality of selected studies was appraised using a checklist adapted from Samadaee-Gelehkolaee (2016).
  
  
  RESULTS
  Of 690 articles retrieved in the search, 190 articles were selected for full text appraisal. Finally, 44 articles were selected for data analysis. The results were classified under three headings: bio-psycho-socioeconomic factors, factors associated with the disease and treatment processes, and physical appearance and sexual function.
  
  
  CONCLUSIONS
  The findings of this review showed that many factors can influence the body image of women suffering from breast cancer. These factors were predictors of patients' inter-personal and intra-personal relationships with their partners and others who influenced various other aspects of their lives, possibly leading to many life's issues. These factors must be identified and considered to make the most appropriate decisions for patients. The strength of this study lies in the exploration of factors influencing the body image of women with breast cancer which earlier studies did not consider. Moreover, the authors believe that this research has addressed nearly all the factors that are real concerns in the body image of women with breast cancer.
authors.affiliation: Student Research Committee, Nasibeh Nursing and Midwifery Faculty, Mazandaran University of Medical Sciences, Sari, IR Iran; Department of Reproductive Health and Midwifery, Mazandaran University of Medical Sciences, Sari, IR Iran.
authors.forename: Maedeh
authors.initials: M
authors.lastname: Rezaei
authors.affiliation: Psychiatry and Behavioral Research Center, Department of Psychiatry, School of Medicine, Mazandaran University of Medical Sciences, Sari, IR Iran.
authors.forename: Forouzan
authors.initials: F
authors.lastname: Elyasi
authors.affiliation: Department of Hematology-Oncology, Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, IR Iran.
authors.forename: Ghasem
authors.initials: G
authors.lastname: Janbabai
authors.affiliation: Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, IR Iran.
authors.forename: Mahmood
authors.initials: M
authors.lastname: Moosazadeh
authors.affiliation: Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, IR Iran; Department of Reproductive Health and Midwifery, Mazandaran University of Medical Sciences, Sari, IR Iran; Traditional and Complementary Medicine Research Center, Mazandaran University of Medical Sciences, Sari, IR Iran.
authors.forename: Zeinab
authors.initials: Z
authors.lastname: Hamzehgardeshi
keywords: Body Image; Breast Cancer; Related Factors; Treatments