Breast Cancer and Body Image: Overcoming Emotional Pain and Building Resilience
Posted by Improving Lives Counseling Services, Inc. | Articles
Here in the United States, it is difficult to find someone who has not been directly or indirectly touched by breast cancer. In 2024, Breastcancer.org reported “1 in 8 women (13%) will develop invasive breast cancer at some point in their life, and the incidence of breast cancer increased by 1% per year between 2012 and 2021. Every year breast cancer accounts for about 30% of all new cancer cases in US Women.” “Breast Cancer Awareness Month, referred to in the United States as National Breast Cancer Awareness Month, is an annual international health campaign organized by major breast cancer charities every October to increase awareness of the disease and raise funds for research into its cause, prevention, diagnosis, treatment, and cure.”
Major breast cancer charities promote Breast Cancer Awareness because the American Cancer Society reports it as one of the most common cancers among American women and this promotion seems to be working. Today, there are more than 3.1 million breast cancer survivors. Increased awareness of the physical and psychological effects of diagnosis, treatment, and impact on families is making a difference, and Improving Lives Counseling Services is helping. Our diverse team of licensed counselors, therapists, and clinicians address the psychological effects of a breast cancer diagnosis on individuals, their families, and caregivers.
BRCA GENETIC TESTING
BRCA1 and BRCA2 are genes that produce proteins that help repair damaged DNA. Everyone has two copies of each of these genes, one inherited from each parent. People who inherit a mutation or pathogenic variant in one of these genes have an increased risk of developing breast cancer – those who experience a “harmful change” in one of these genes tend to develop cancer at a much younger age. More than 60% of women who inherit a harmful change in BRCA1 or BRCA2 will develop breast cancer during their lifetime.
While it is understood that no scientific test is perfect, many women (and men) do not take advantage of the insight genetic testing can offer. Having a BRCA mutation means there is a 45% to 85% likelihood of developing breast cancer in one’s lifetime. Yet, the knowledge that there are no false positives in BRCA testing, along with the implications for health, treatment, and mortality, many fear the results would be emotionally overwhelming and could lead to long-term anxiety and chronic stress. The National Cancer Institute suggests, “Before having testing, people should discuss with their genetic counselor both the benefits and possible downsides of genetic testing.
MAMMOGRAPHY
Currently mammography is recommended to screen for breast cancer and to reduce breast cancer mortality. In 2024, the National Institute of Health reported “overall 88% of physicians recommended mammography to women ages 45-49 and 67% to women ages 75+, yet the United States Preventive Services’ Task Force recommends that “all women get screened for breast cancer every other year, starting at age 40, and continuing through age 74 to reduce their risk of dying from the disease.” Despite multiple organizations stressing the importance of mammograms, the Centers for Disease Control (CDC) found only 50% of women who “did not” have a healthcare provider had regular mammograms. That number increased to over 80% for women who “had” a healthcare provider.
The reasons women (and men) might not get mammograms are the same reasons they avoid BRCA gene testing: access, cost, fear of results, anxiety, cultural beliefs, stigma, health issues, education, and understanding. Approximately 40,000 women die from breast cancer each year. Addressing these barriers through education, accessibility, and support can help encourage more women to participate in gene testing and regular mammogram screenings.
MENTAL HEALTH – EFFECTS
Simply hearing the words “you have breast cancer” can cause a patient to zone out. Physicians often find themselves repeating the diagnosis, treatment options, and prognosis multiple times. Because a breast cancer diagnosis can create psychological distress, many physicians encourage patients to bring a spouse, partner, or family member to the appointment for support.
Emotional Pain
Feelings of sadness, hopelessness, loneliness, and sorrow can trigger chronic anxiety and stress. The uncertainty surrounding how the diagnosis and treatment will impact daily life, work, or school, as well as body image, can lead to depression. The diagnosis can strain relationships with partners as in-home roles shift and lifestyle dynamics change.
“The emotional turmoil that comes with a breast cancer diagnosis can be explained in the five stages of grief: denial, anger, bargaining, depression, and acceptance. As women begin the lengthy treatment process and settle into their diagnosis, they are often faced with new programs, physical pain, side effects from the treatment, exhaustion, and worry. Many women will lose that intimate spark with their partner due to low self-esteem.”
The list of things to worry about or stress over can be long: Will my employer give me time off for treatments? Will I have to take a leave of absence? Who will transport my children to and from school? Will they have to quit their extracurricular activities? Will I need to find childcare and transportation to and from appointments? Who will stay with me in the hours following treatment? How will our lifestyle change? Other concerns include financial issues, such as whether there is paid time off, how much treatment will cost, and whether insurance will cover it. For uninsured patients, and single parent households, anxiety multiplies as they face a financial crisis wondering how they will support their families.
Emotional Crisis
Breast cancer patients often withdraw socially and isolate themselves due to stigma, feelings of inadequacy, and helplessness. When treatment begins, they may feel burdensome, as if they’re inconveniencing or frustrating others. Rapid shifts in emotions, accompanied by symptoms of guilt, shame, blame, cruelty, and fear, can spiral out of control, placing the patient in crisis. Stress related to body image may lead to promiscuity, while financial worries can contribute to criminality. According to Science Direct, just over 2% of patients diagnosed with breast cancer have committed suicide, with the highest rates among those aged 70 to 80, followed by those aged 20 to 39. Chronic stress, heightened anxiety, and depression can affect the body’s immune system and hormonal balance, potentially impacting breast cancer treatment and recovery.
Cancer / Treatment Pain – Emotional Effects
Cancer pain is pain caused by cancer or its treatment. Studies show pain is one of the most common and feared symptoms associated with the disease. Cancer pain can significantly affect quality of life, making certain symptoms and treatment side effects feel worse. It may increase the risk of developing depression, ongoing trauma, and PTSD.
SUMMARY
The days following a breast cancer diagnosis can be emotionally overwhelming. It can be difficult to think clearly, decide when and with whom to share the diagnosis, and how to find sources of support. As patients seek information and grapple with their understanding, they may wonder whether they should take another test, get a second opinion, or better understand their prognosis before moving forward with treatment. Counseling immediately after the diagnosis and before treatment begins is crucial, as is discussing pain and pain management. Patients report that pain alone can increase feelings of melancholy and depression.
Breast cancer patients may experience behavioral disorders, PTSD, and suicidal thoughts. The suicide rate among breast cancer patients is higher than that in the general population. Therefore every patient suspected of having breast cancer should becounseled before and after diagnosis to psychologically prepare them for treatment.
Improving Lives Counseling Services’ diverse team of licensed, trained, professional counselors, therapists, and clinicians treat the psychological, emotional, and behavioral modalities associated with a diagnosis of breast cancer – before, during, and after treatment, in individual, couple’s, family, and group sessions. Counseling is also available for individuals considering BRCA gene tests. Call us to learn more.
