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.
Highlights
Breast cancer is one of the most common tumors among women (Ferlay et al, 2015; Andreis et al, 2018)
The aim of this study is to evaluate the efficacy of different kinds of psychological interventions on body image (BI) and sexual functioning in breast cancer patients and breast cancer survivors
Since we only aimed to explore the efficacy of psychological interventions for BI in breast cancer patients and survivors, we decided to exclude studies that did not use psychological interventions, studies that explicitly state in the article that the intervention was not conducted by trained psychologists, or studies in which the psychological intervention is not used alone, but was
Summary
Breast cancer is one of the most common tumors among women (Ferlay et al, 2015; Andreis et al, 2018). Despite a fairly good prognosis, cancer diagnosis and treatments concur to both negative physical and psychological long termside effects that affect patients’ and survivors’ quality of life (QOL; Sterba et al, 2014; Ahmad et al, 2015; Williams and Jeanetta, 2016). 4) that involves the mental representation of one’s own body and related emotions within an overall sense of bodily self (Lewis-Smith et al, 2018; Sebri et al, 2020b). Breast cancer patients and survivors’ evaluation of their own physical appearance as well as attitudes toward the body notably change, especially in terms of femininity and sexuality (Maass et al, 2015; Sherman et al, 2018). Patients’ and survivors’ BI in terms of sexuality is altered by the fear of loss of fertility, induced menopause, and perception of sexual unattractiveness, linked to perceived partner’s greater difficulties to understand their feelings (Woertman and Van den Brink, 2012)
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