The Efficacy of Psychological Intervention on Body Image in Breast Cancer Patients and Survivors: A Systematic-Review and Meta-Analysis

Abstract

The experience of breast cancer and related treatments has notable effects on women's mental health. Among them, the subjective perception of the body or body image (BI) is altered. Such alterations deserve to be properly treated because they augment the risk for depression and mood disorders, and impair intimate relationships. A number of studies revealed that focused psychological interventions are effective in reducing BI issues related to breast cancer. However, findings are inconsistent regarding the dimension of such effects. This meta-analysis synthesizes and quantifies the efficacy of psychological interventions for BI in breast cancer patients and survivors. Additionally, since sexual functioning emerged as a relevant aspect in the BI distortions, we explored the efficacy of psychological interventions on sexual functioning related to BI in breast cancer patients and survivors. The literature search for relevant contributions was carried out in March 2020 through the following electronic databases: Scopus, PsycINFO, and ProQUEST. Only articles available in English and that featured psychological interventions for body image in breast cancer patients or survivors with controls were included. Seven articles with 17 dependent effect sizes were selected for this meta-analysis. Variables were grouped into: Body Image (six studies, nine dependent effect sizes) and Sexual Functioning Related to the Body Image in breast cancer patients and survivors (four studies, eight dependent effect sizes). The three-level meta-analysis showed a statistically significant effect for Body Image [g = 0.50; 95% CI (0.08; 0.93); p < 0.05] but no significant results for Sexual Functioning Related to Body Image [g = 0.33; 95% CI (−0.20; 0.85); p = 0.19]. These results suggest that psychological interventions are effective in reducing body image issues but not in reducing sexual functioning issues related to body image in breast cancer patients and survivors. Future review efforts may include gray literature and qualitative studies to better understand body image and sexual functioning issues in breast cancer patients. Also, high-quality studies are needed to inform future meta-analyses.

Breast-related and body-related quality of life following autologous breast reconstruction is superior to implant-based breast reconstruction - A long-term follow-up study

“…Protective factors such as a strong romantic relationship or postmenopausal age may explain why some women suffer less from a distorted self-perception than others [ 39 , 40 ]. Different, but not all types of psychosocial interventions on body image outcomes were shown to be effective with varying effect sizes [ [41] , [42] , [43] ]. Breast reconstruction aims to mitigate body image distress by restoring the appearance of the breast.…”

The Impact of Unsupportive Social Support on the Injured Self in Breast Cancer Patients

“…Discrepancy between selves, as well as lack of integration in one self-representation, have been consistently linked to mental and physical health issues (Higgins et al, 1985;Mason et al, 2019;Triberti et al, 2019;Sebri et al, 2021a). The experience of chronic illness can affect the perception on both bodily and narrative self-representations Specifically, oncological treatments can alter patients' self-concept as they experience consequences (or effects) of treatments (such as hair loss, sexual disturbances or breast removal) (Clemmey and Nicassio, 1997;Sebri et al, 2021b). In this sense, patients can perceive their bodies as a source of danger and fear (Sebri et al, 2021b) and adopt compulsive "checking behaviors" (Butow et al, 2018).…”

“…The experience of chronic illness can affect the perception on both bodily and narrative self-representations Specifically, oncological treatments can alter patients' self-concept as they experience consequences (or effects) of treatments (such as hair loss, sexual disturbances or breast removal) (Clemmey and Nicassio, 1997;Sebri et al, 2021b). In this sense, patients can perceive their bodies as a source of danger and fear (Sebri et al, 2021b) and adopt compulsive "checking behaviors" (Butow et al, 2018). After the breast cancer experience, interoceptive sensations can become more and more salient, increasing survivors' attention to bodily signals that are possibly related to one's own health, for example touching sensitive areas of their breast looking for nodules (McGinty et al, 2016).…”

Association of Insomnia, Depressive Disorders, and Mood Disorders as Risk Factors With Breast Cancer: A Nationwide Population-Based Cohort Study of 232,108 Women in Taiwan

“…Disruption of body imagerelated (hair loss, weight gain, aesthetics, etc.) distress could be alleviated via psychological intervention (7,8). Breast cancerrelated fatigue is also a major issue influencing quality of life, and some rehabilitation protocols like aerobic exercise could help (9).…”