How Breast Cancer Impacts Your Body Image
Breast cancer and its treatment may change how you feel about your body. You may be coping with scars, pain, weight gain or loss, hair loss or thinning, sexual side effects, changes in sensation, or lymphedema.
Other side effects, including hot flashes related to early menopause or fatigue that prevents you from being as active as you were before breast cancer, can leave you feeling less confident or in control of your body.
Though these side effects are common, you might be surprised when they arise. You may feel unprepared to deal with emotional reactions to these changes.
Body image concerns surprise women because the first priority after diagnosis is treating the cancer. You might feel rushed into making decisions about what type of surgery to get, and then be unhappy with how you feel and look physically after the surgery. Or you may have wanted to start treatment immediately and didn’t think about how you might feel afterwards.
Everyone responds differently to physical changes caused by breast cancer. Your reaction may depend on many different factors, including:
- Your age
- How important your appearance and a sense of femininity is to you
- How breasts, hair and other physical features affect how you see yourself
- How you felt about your body before diagnosis
- If you ever experienced sexual abuse or serious illness
Your response to change comes from your individual perspective, which is shaped by past experiences, personality and, sometimes, by support from family and friends. These changes could feel different depending on your age and relationship status. Whether your breasts or hair are important to you and whether you see your scars as unwanted marks or as signs of your strength is unique to you.
Radiation can cause skin changes such as thinning of the skin and discoloration, and the incisions of surgery, including lumpectomy, can leave permanent scars. It can help to look at pictures of women who have had breast cancer surgery or radiation to see what their bodies and scars look like afterwards.
The scar may be a visible reminder of what you have been through. You may be worried that the scars will always look as big and scary as they do right after treatment. Thankfully, what is at first a big red line or patch often becomes much less visible over time.
Still, you might be afraid to look at the scars on or around your breast area after lumpectomy or mastectomy. You might worry about the reaction of your current sexual partner or potential partners.
As you heal from breast cancer surgery, it helps to look at your body and feel the scars so you get used to the changes and feel more comfortable with them. You don’t have to do this all at once or right away. But don’t wait too long, because the more you look and touch your changed body, the more comfortable you can become with the changes. If you have a sexual partner, it also helps to let him or her see and touch your scars.
After breast cancer treatment, you may find that your body looks different or even has a different shape. This is not just the result of breast cancer surgery, but can happen due to weight gain or loss caused by treatment. Changes in weight can have a negative effect on your body image.
For many women, weight gain during treatment is the hardest to deal with. We don’t know exactly why, but about half of women undergoing breast cancer treatment gain weight. Often this is just a few pounds, but some women can gain more.
If you were trying to gain weight or build muscle before your diagnosis, losing that weight and muscle can be hard. Even if you are an athlete, you may not have been able to exercise as often as you wanted during treatment. Your body may also have changed shape because of lost muscle definition or lost weight. It can be frustrating to find your body can’t do the things it could do before cancer. Remember that there are ways to work out safely while in treatment, even if it’s not as hard as you did before. Meeting with a personal trainer with experience working with people with cancer can also help.
Give Yourself Time
Giving yourself time and starting to exercise gradually is important, even though it may not make you feel great about your body right away. This is true whether you’ve had cancer or not.
Research shows that having a healthy diet with lots of fruits and vegetables and getting regular exercise can keep you healthy whether or not you lose weight. And when your body is strong and healthy, you feel better about yourself.
Learn more about fitness and exercise.
Chemotherapy can cause you to lose not just the hair on your head, but also eyelashes, eyebrows, and pubic hair. It can also cause dry, flaky skin. Radiation can change the color of the skin and make it look and feel like you have sunburn.
All of these changes can have a big impact on your body image if your hair and skin were important to your sense of self before cancer. For many women, the most shocking is losing their hair, because hair is often closely related to a woman’s sense of beauty and attractiveness. If you have children, they may react strongly to your hair loss, which can add to your own distress.
How you react to hair loss also depends on your personality and life situation. You may find that hair loss reminds you of the temporary loss of your good health, or you might hate losing control over your appearance. You also might not mind losing your arm, leg or pubic hair; many women shave or wax these areas, and temporary hair loss can be a welcome break from having to do so.
For the most part, these changes are temporary. Your hair will grow back after treatment and your skin will return to its normal color. Some women do find that the hair on their head grows back with a different texture than it was before: straight hair might grow back curly.
For some women being feminine means having beautiful hair and a curvy figure. If this is true for you, when you lose your hair, have a breast removed or gain or lose too much weight, how you feel about yourself as a woman can suffer.
Feeling feminine can also be related to having a satisfying sexual life. But breast cancer treatments can have sexual side effects, like vaginal dryness and other menopausal symptoms that impact how comfortable you are with sex.
Feeling like you’re less feminine because you’ve lost a breast or because it’s harder for you to enjoy sex are all aspects of negative body image. You might worry about how your partner will respond to how you look during and after treatment, or that being less interested in sex makes you less feminine.
Remember that being feminine is a lot more than just having breasts and feeling sexy. There are many ways to feel empowered and strong, including wearing clothes that make you feel confident in yourself, and doing activities that make you feel good about being a woman.
All of the physical changes associated with breast cancer can make you feel less sure of yourself.
You may feel that other people are thinking negative thoughts about you, pitying you, think you are too sick to do what you normally do, or are not attracted to you. Your friends and colleagues may make comments about how you look that make you feel bad, even if that’s not what they intended.
These are all difficult reactions and situations to deal with. If you feel that your loss of confidence is making you feel bad not just about your appearance but about other aspects of your life, you may find it helpful to talk to a professional counselor or to other women who are going through the same experiences.
Women with a history of breast cancer may have lower sexual desire, lower ability to reach orgasm, more sex-related pain and less sex than women who have not had breast cancer.
Even if the desire is there, you might feel uncomfortable about the changes that your body has gone through after breast cancer treatment. You may be afraid that your partner won’t be excited by, or accepting of, your body as it appears now.
For women whose breasts are part of their arousal (and for some, breast play can be a trigger for orgasm), the loss of the breast or breasts can have a significant and distressing impact on their sexual response and sexual satisfaction.
Try to be open and honest with your partner about what you’re feeling and encourage your partner to do the same. Seeking advice from a couples counselor or sex therapist may also be helpful.
Keep in mind that sex and intimacy are two different things. Holding hands, hugging and doing other non-sexual things with your partner can maintain the intimacy in your relationship, even if you aren’t having sex.
If you’re single, telling potential new partners about your history of breast cancer may make you nervous. It may help to take new relationships slowly. When thinking about telling a date about your diagnosis, practice what you’re going to say in a mirror first. Don’t be shy about ending the relationship if the person can’t handle your diagnosis.