woman and doctor 

Long after a diagnosis of breast cancer, many women face a range of emotional struggles – especially body-image issues. A small but important section in the new Breast Cancer Survivorship Care Guideline from the American Cancer Society and the American Society of Clinical Oncology (ASCO) advises primary care doctors and other clinicians on ways to help restore their patients’ self-esteem.

The guideline details options for physical enhancements, including breast forms/prosthesis and specialty bras that may require a prescription. It also notes that many breast cancer care centers can help women find wigs, scarves, and other products. When such implements aren’t enough to correct self-image concerns, psychosocial interventions are recommended. Examples include support groups, psychotherapy, cognitive behavioral therapy, and couple-based interventions.

Concerns about body image affect from 31% to 67% of the estimated 3.1 million survivors, according to the guideline. Hair loss, mastectomy (with or without reconstruction), and poorer mental health are some of the most common self-image concerns. The studies behind the new guideline underscore the importance of addressing the invisible scars of breast cancer.

“We provide prevalence figures so health care providers understand that body image is a major concern, and evidence-based recommendations for how to better manage these issues,” said Corinne Leach, MPH, PHD, strategic director of cancer and aging research at the American Cancer Society. She was on the multidisciplinary team that helped develop the recommendations. “We go beyond telling health care providers what the problem is. We also tell them how they can help in ways that are backed by scientific evidence.”

The full survivorship guideline, which was published in December in the American Cancer Society’s CA: A Cancer Journal for Clinicians and ASCO’s Journal of Clinical Oncology, also includes recommendations on surveillance for breast cancer recurrence, health promotion and more. More than 230 studies were included in the evidence base.

“We hope these guidelines improve the quality of care for women with a history of breast cancer in numerous ways,” said Leach.

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