Body Image and the Decision-Making Process in Breast Cancer Patients

PURPOSE: Breast cancer in combination with consecutive surgery of the breast may have numerous psychological consequences. The decision-making process for the operative approach is determined by the preoperative findings and also depends to a large extent on the patient's wishes. MATERIAL AND METHODS: Between January 2001 and January 2004, 60 breast cancer patients agreed to participate in this case control study. Interviews were carried out in the early postoperative stage. To evaluate the patients' body image we used a questionnaire based on the patient's assessment of her own body (FBeK). RESULTS: The mean scores of the FBeK scales for breast cancer patients were higher than those of healthy controls. A comparison of the scores, correlated to the operative intervention, showed a significant difference for scale 4 (p = 0.002). Patients after mastectomy were more satisfied than patients having undergone conservative breast surgery. Being able to personally influence the decision-making process was very important for 68.3 % of the patients (n = 41). The decision-making process was of greater importance for women with a mastectomy than for women with a breast-conserving therapy (p = 0.005). Most patients confirmed the assumption that their decision was shared with the doctor. DISCUSSION: Early postoperative reactions to breast cancer are influenced by the coping process and defence mechanisms. Problems with body image may be relevant only at a later time point. Therefore the oncological follow-up is highly important for patients and there should be enough time to discuss body image issues repeatedly during the course of disease.