Body image concerns among women diagnosed with breast cancer in a South Asian setting: a phenomenology approach

Abstract

Background: Breast cancer, the most common malignancy among women, causes significant physical and psychological impacts. Body image concerns are particularly distressing. Unlike in high-income countries, studies exploring body image concerns among breast cancer patients in lower-middle-income settings, such as Sri Lanka, are limited. This study aims to address this gap by exploring the body image concerns of women diagnosed with breast cancer in Sri Lanka using a phenomenological approach. Methods: A qualitative study using a phenomenological approach was conducted among 17 women diagnosed with breast cancer, receiving treatment at the National Cancer Institute, Maharagama, a leading government oncology hospital in Sri Lanka. Participants were selected through purposive sampling. Data was collected using in-depth interviews based on a semi-structured interview guide until the point of saturation was reached. Interviews were audio-recorded with informed consent, transcribed verbatim, and analyzed using thematic analysis. Non-verbal cues were documented to capture emotional and psychological responses. Results: The study included 17 women aged 32–65 years; the majority were married (88.2%) and employed (70.5%). Thematic analysis revealed four key themes: (1) Physical concerns(n = 17) —hair loss, general appearance changes, mastectomy-related disfigurement, weight fluctuations, and skin discoloration; (2) Psychological concerns(n = 14)—distress, low self-esteem, and social stigma; (3) Social challenges(n = 11) —relationship strain and social withdrawal; and (4) Coping strategies(n = 11)—wigs, prostheses, mastectomy bras, counselling, and social support networks. Physical concerns were the most frequent theme, and the majority’s concerns were related to hair loss. Conclusion: This study highlights the profound impact of body image concerns among Sri Lankan women with breast cancer. The findings emphasize the need for holistic cancer care integrating psychosocial support to improve patients’ quality of life. Future research should focus on developing culturally sensitive interventions tailored to the needs of breast cancer patients in resource-limited settings.