Beyond body image: the experience of breast cancer.

PURPOSE/OBJECTIVES: To describe the mental and emotional impact of treatment for breast cancer with a focus on the ways the body is experienced.

DESIGN

Phenomenologic, descriptive, and interpretive.

SETTING

An outpatient treatment area of a comprehensive cancer center in the southwestern United States.

SAMPLE

20 women, ages 20-68 (mean = 50 years), who had mastectomies (including both modified radical mastectomies and lumpectomies, with some having reconstruction) for breast cancer.

METHODS

Content analysis of verbatim transcriptions of open-ended interviews using hermeneutic phenomenology and descriptive and interpretive presentation of a paradigm case.

MAIN RESEARCH VARIABLES

Reaction to breast cancer and its treatment.

FINDINGS

Informants' descriptions demonstrate that the body can be viewed as having three aspects: (a) the body as symbol or social expression (i.e., how bodies make a social statement and tell others who you are); (b) the body as a way of being in the world, including sensations and symptoms such as nausea, fatigue, and pain; and (c) the existential sense that one needs a body to be in the world (i.e., the body expresses existence), which led to more awareness of the possibility of death.

CONCLUSIONS

Women treated for breast cancer view their bodies in ways that go beyond what is suggested by the literature on body image and breast cancer, encompassing a wide range of responses.

IMPLICATIONS FOR NURSING PRACTICE

The contribution of this study is the documentation of the complexity of the meaning of "body" for women with breast cancer. Appropriate interventions differ for each aspect of the body: for the body as social symbol, programs such as Look Good ... Feel Better or image centers; for the body's sensations and symptoms, information about what to expect and about symptom prevention and management; for the existential body, active listening to fears and concerns and providing assistance as needed.