title: Distress and body image due to altered appearance in posttreatment and active treatment of breast cancer patients and in general population controls.
abstract: ABSTRACTObjective: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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.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.
authors.forename: Danbee
authors.initials: D
authors.lastname: Kang
authors.affiliation: Cancer Education Center,Samsung Comprehensive Cancer Center,Samsung Medical Center,Sungkyunkwan University School of Medicine,Seoul,Korea.
authors.forename: Eun-Kyung
authors.initials: EK
authors.lastname: Choi
authors.affiliation: Cancer Education Center,Samsung Comprehensive Cancer Center,Samsung Medical Center,Sungkyunkwan University School of Medicine,Seoul,Korea.
authors.forename: Im-Ryung
authors.initials: IR
authors.lastname: Kim
authors.affiliation: Department of Surgery,Samsung Medical Center,Sungkyunkwan University School of Medicine,Seoul,Korea.
authors.forename: Seok Jin
authors.initials: SJ
authors.lastname: Nam
authors.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.
authors.forename: Jeong Eon
authors.initials: JE
authors.lastname: Lee
authors.affiliation: Department of Hematology and Oncology,Samsung Medical Center,Sungkyunkwan University School of Medicine,Seoul,Korea.
authors.forename: Young-Hyuck
authors.initials: YH
authors.lastname: Im
authors.affiliation: Department of Hematology and Oncology,Samsung Medical Center,Sungkyunkwan University School of Medicine,Seoul,Korea.
authors.forename: Jin Seok
authors.initials: JS
authors.lastname: Ahn
authors.affiliation: Departments of Health, Behavior, and Society and Epidemiology,Johns Hopkins Bloomberg School of Public Health,Baltimore,Maryland,USA.
authors.forename: Yeon Hee
authors.initials: YH
authors.lastname: Park
authors.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.
authors.forename: Juhee
authors.identifier: 0000-0001-9081-0266
authors.initials: J
authors.lastname: Cho
mesh_terms: D000328:Adult; D001828:Body Image / Q000523:psychology*; D001943:Breast Neoplasms / Q000150:complications / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D011155:Population Control / Q000379:methods; D011788:Quality of Life / Q000523:psychology; D013315:Stress, Psychological / Q000209:etiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology
keywords: Altered appearance; Body image; Breast cancer; Distress; Survivorship