乳腺癌幸存者的身体意象：治疗引起的绝经及生育担忧的年龄调节效应
Body image in breast cancer survivors: Age-moderated effects of treatment-induced menopause and fertility concerns.
作者信息
Sheffi Oshri Saar, Paluch-Shimon Shani, Goldzwieg Gil, Rotchild Shiran Klein, Braun Michal
机构信息
Breast Oncology Unit, Hadassah University Hospital, Jerusalem, Israel; School of Behavioral Sciences, Tel-Aviv-Yaffo Academic College, Tel-Aviv, Israel.
Breast Oncology Unit, Hadassah University Hospital, Jerusalem, Israel; Faculty of Medicine, Hebrew University, Jerusalem, Israel.
出版信息
Breast. 2025 Jun 5;82:104512. doi: 10.1016/j.breast.2025.104512.
PURPOSE
Hormone receptor-positive breast cancer survivors undergoing endocrine therapy face significant body image challenges. This study aimed to examine differences in body image between hormone receptor-positive breast cancer survivors receiving endocrine therapy and unaffected, healthy women. Specifically, we investigated whether treatment-induced menopausal symptoms and fertility concerns mediate the relationship between breast cancer survivorship and body image. Additionally, we explored whether age moderates these mediation effects, assessing whether the strength of these indirect relationships varies across different age groups.
METHODS
121 hormone receptor-positive breast cancer survivors and 114 healthy women completed a sociodemographic questionnaire, the Body Image Scale (BIS), the Menopausal Rating Scale (MRS), and the Reproductive Concerns Scale (RCS). Breast cancer survivors also completed a medical data questionnaire.
RESULTS
Hormone receptor-positive breast cancer survivors reported significantly higher levels of negative body image, menopausal symptoms, and fertility concerns compared to healthy women. Moderated mediation analyses revealed that both menopausal symptoms and fertility concerns mediated the relationship between breast cancer and body image, with age moderating these relationships. The indirect effects were stronger among younger women and diminished with age. The mediating effect through menopausal symptoms was particularly pronounced for somatic and urogenital symptoms.
CONCLUSIONS
These results highlight the significant role of treatment-induced menopausal symptoms and fertility concerns in shaping body image among young hormone receptor-positive breast cancer survivors. These young women should be provided with targeted information and interventions that will help them cope with treatment-related side effects and maintain positive body image as part of the recovery process.
目的
接受内分泌治疗的激素受体阳性乳腺癌幸存者面临着显著的身体形象挑战。本研究旨在探讨接受内分泌治疗的激素受体阳性乳腺癌幸存者与未受影响的健康女性在身体形象方面的差异。具体而言，我们调查了治疗引起的更年期症状和生育问题是否介导了乳腺癌幸存者身份与身体形象之间的关系。此外，我们还探讨了年龄是否调节这些中介效应，评估这些间接关系的强度在不同年龄组中是否有所不同。
方法
121名激素受体阳性乳腺癌幸存者和114名健康女性完成了一份社会人口统计学问卷、身体形象量表（BIS）、更年期评定量表（MRS）和生殖问题量表（RCS）。乳腺癌幸存者还完成了一份医疗数据问卷。
结果
与健康女性相比，激素受体阳性乳腺癌幸存者报告的负面身体形象、更年期症状和生育问题水平显著更高。调节中介分析显示，更年期症状和生育问题均介导了乳腺癌与身体形象之间的关系，年龄调节了这些关系。间接效应在年轻女性中更强，且随年龄增长而减弱。通过更年期症状的中介效应在躯体和泌尿生殖系统症状方面尤为明显。
结论
这些结果突出了治疗引起的更年期症状和生育问题在塑造年轻激素受体阳性乳腺癌幸存者身体形象方面的重要作用。应为这些年轻女性提供有针对性的信息和干预措施，以帮助她们应对与治疗相关的副作用，并在康复过程中保持积极的身体形象。
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