Atenção oncológica a mulheres com câncer de mama: avaliação do impacto na imagem corporal e fatores associados

Abstract

Background: Breast cancer is the most common malignant neoplasm among women worldwide, affecting not only physical health but also emotional and psychosocial dimensions, such as body image perception. Bodily changes resulting from cancer treatment can lead to body dissatisfaction, negatively impacting self-esteem, social reintegration, and the quality of life of female survivors. Objective: To assess the impact of breast cancer on body image and identify sociodemographic, clinical, behavioral, and social factors associated with body dissatisfaction among women receiving care at oncology referral centers. Methods: This is a cross-sectional study nested within a hospital-based cohort of women diagnosed with breast cancer between 2014 and 2016 in Juiz de Fora, a municipality in the Zona da Mata region of Minas Gerais, Brazil. The sample consisted of 101 women, with an average age of 53.55 years (SD=12.19) under outpatient follow-up in oncology services. Body image was assessed using the Body Image after Breast Cancer Questionnaire (BIBCQ), validated for the Brazilian context. Sociodemographic, clinical, behavioral, and social support data were collected through a survey. Descriptive statistics and Pearson’s chi-square test were used to identify associations between the outcome variable (body dissatisfaction) and independent variables. Variables with p ≤ 0.20 were included in a multivariate binary logistic regression analysis using a backward stepwise method. Only variables with p ≤ 0.05 were retained in the final model. Statistical analyses were performed using SPSS software. Results: The prevalence of body dissatisfaction was 47.5%. Higher odds of body dissatisfaction were associated with being 49 years old or younger (OR = 3.25; 95% CI: 1.34–7.89), engaging in regular physical activity (OR = 2.81; 95% CI: 1.12–7.05), consuming fewer than four alcoholic drinks per occasion (OR = 2.74; 95% CI: 1.08–6.91), and reporting lower perceived social support (OR = 3.45; 95% CI: 1.34–8.85). Clinical factors, such as cancer staging and treatment type, were not significantly associated with body dissatisfaction. Conclusion: Body dissatisfaction is a prevalent outcome among breast cancer survivors and is influenced more by sociodemographic, behavioral and social support factors than by clinical characteristics of the disease. These findings underscore the need to integrate psychosocial care strategies into oncology services to address patients’ subjective needs and promote better quality of life throughout the cancer care continuum and survivorship.