Body image and self-esteem in women with breast cancer – the role of body acceptance

Introduction
Breast cancer treatments have an influence on alterations of women’s appearance and perceived femininity. Many studies have shown that body image problems are related to low self-esteem and feeling less attractive.

The aim of the study
To compare self-esteem and body image in younger and older women and in women with breast reconstruction and without reconstruction, evaluate factors associated with self-esteem in women with breast cancer, who had mastectomy or breast-conserving surgery, and to analyse the role of body acceptance as a mediator of the relationship between the body image and self-esteem.

Material and methods
The research group consisted of a total of 105 women with breast cancer, 99 after radical mastectomy surgery (including 19 after breast reconstruction surgery), 6 after a sparing surgery. The Rosenberg Self-Esteem Scale (SES), the Body Image Scale of Hopwood et al. (BIS), and the Scale of Self-Attractiveness in a Relationship of Chybicka and Karasiewicz were used in the investigation.

Results
The differences in self-esteem and body image were found to be dependent on women’s age. Breast reconstruction differentiated women in terms of self-esteem, but it was not related to the body image. The image of the altered body was a strongly negative predictor of self-esteem. Body acceptance fully mediated the relationship between body image and self-esteem. 

Conclusions
The distress associated with changed body image negatively affects the self-esteem of women with breast cancer. However, self-acceptance of the body can be understood as a protective factor that eliminates the negative effects of the above dependence, which can be an important indication for clinicians.