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.