The body image drawing analysis in women with breast disease and breast cancer: anxiety, colour and depression categories.

BACKGROUND

Wirsching et al. introduced a psychosocial risk scale (PRS) for psychological identification of breast cancer patients before biopsy and found that women with cancer had a tendency to draw bigger drawings than the women with a benign tumour. To our knowledge, the associations between the body image drawing analysis and the risk of breast cancer are rarely considered together in a prospective study.

PATIENTS AND METHODS

This study is an extension of the Kuopio Breast Cancer Study. Women with breast symptoms were referred by physicians to the Kuopio University Hospital (Finland) and were asked to participate in this study. These women (n=115) were interviewed, and all study variables were obtained before any diagnostic procedures were carried out, so neither the investigator nor the participants knew the final diagnosis of breast symptoms at the time of the interview. The research method used was the semistructured in-depth interview method. The investigator used the Montgomery-Asberg depression rating scale (MADRS) to evaluate the depression of the study participants. All participants were also asked to complete standardized questionnaires (Beck depression inventory and Spielberger trait inventory). The overall content of the Body Image Drawing was estimated using a 3-point scale: symbolistic, partly symbolistic, or humanlike. Two raters scored the body image drawings independently and the final scores were formed by comparing the separate scores of the two raters. The raters evaluated the difficulty of giving a score in a 5-point scale during scoring.

RESULTS

The clinical examination and biopsy showed breast cancer (BC) in 34 patients, benign breast disease (BBD) in 53 patients, and 28 individuals were shown to be healthy (HSS). The results indicated that the breast cancer patients tended to use the colours with blue and the tones of brown and black in the body image drawings than the BBD and HSS groups. The HSS group used the colours with yellow more often than did the other groups.

CONCLUSION

The results of this study support a weak association between the colour category of the body image drawing and breast cancer risk. However, the biological explanation for such an association is unclear and the exact effects of psychological factors on the various hormones relevant to development of breast cancer are, at present, poorly defined.