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“当我照镜子时,我希望看到一个健康的身体”:年轻的癌症高危女性双侧预防性乳房切除术及身体形象的生活体验

"When I Look in the Mirror, I Want to See a Healthy Body": The Lived Experience of Young Previvors, Bilateral Risk-Reducing Mastectomy, and Body Image.

作者信息

Torrisi Christa, Fu Mei R, Teti Michelle, Armer Jane M

机构信息

Indiana University, Indianapolis, USA.

University of Missouri, Kansas City, USA.

出版信息

Glob Qual Nurs Res. 2025 Aug 7;12:23333936251362638. doi: 10.1177/23333936251362638. eCollection 2025 Jan-Dec.

Abstract

Breast cancer is a significant cause of cancer death in young women in the United States. Inherited pathogenic variants, like BRCA1 and BRCA2, contribute to an increased lifetime breast cancer risk in this population. For women with a known pathogenic variant but without a previous cancer diagnosis, also known as "previvors," the bilateral risk-reducing mastectomy (BRRM) most effectively reduces breast cancer risk. However, this surgery often causes physical change to the body. While existing research has examined the effect of BRRM and body image among previvors across the lifespan, the effect of prophylactic breast removal to decrease lifetime breast cancer risk in young previvors less than 40 years of age is less understood. A descriptive phenomenological approach, along with participant-submitted images, from a sample of 13 young previvors from the Midwestern United States, aged 29 to 39, explored the lived experience of BRRM and body image in the first 12 months following surgery. Narrative data served as the primary source, augmented by participant-submitted visual data. Essential themes were intuited to include BRRM to promote health, the importance of adaptation and acceptance to a changed body, and unexpected challenges following surgery; body image was found to be largely positive after healing occurred.

摘要

乳腺癌是美国年轻女性癌症死亡的一个重要原因。像BRCA1和BRCA2这样的遗传性致病变异会增加该人群一生中患乳腺癌的风险。对于已知有致病变异但此前未被诊断出患有癌症的女性,也就是所谓的“癌症未患先防者”,双侧预防性乳房切除术(BRRM)能最有效地降低患乳腺癌的风险。然而,这种手术常常会给身体带来生理变化。虽然现有研究已经考察了BRRM对癌症未患先防者一生中身体形象的影响,但对于40岁以下的年轻癌症未患先防者而言,预防性乳房切除以降低一生中患乳腺癌风险的效果却鲜为人知。本研究采用描述性现象学方法,并结合参与者提交的图像,对来自美国中西部地区的13名年龄在29至39岁之间的年轻癌症未患先防者进行了抽样调查,探讨了她们在手术后12个月内BRRM及身体形象的生活体验。叙事性数据作为主要来源,并通过参与者提交的视觉数据加以补充。研究直观得出的基本主题包括:BRRM促进健康、适应和接受身体变化的重要性以及手术后出现的意外挑战;研究发现,愈合后身体形象在很大程度上是积极的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a49/12332254/9bafd7a1a5a9/10.1177_23333936251362638-fig1.jpg

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