The Coping Styles and Perception of Illness in Patients with Breast Cancer-Relation to Body Image and Type of Surgery

Breast cancer is considered one of the most frequent causes of morbidity and death in women. Individuals' response to information regarding health threats and illness can influence the adjustment of the treatment to existing conditions including the issues of non-completion of treatment or non-attendance at medical appointments. The study aimed to examine the relationship between illness perception, body image dissatisfaction and (mal)adaptive coping styles in breast cancer patients. A sample of 197 patients with diagnosed breast cancer hospitalized at the Center for Oncology and Radiology, Kragujevac, Serbia, was surveyed. The instruments included sociodemographic questionnaire, a Brief Illness Perception Questionnaire (BIPQ), a Body Image Scale (BIS), and a Mini-Mental Adjustment to Cancer Scale (Mini-MA & Scy;). Results showed that 52% of the variance of maladaptive coping style in women who underwent mastectomy was explained by the negative illness perception, while body image dissatisfaction reflected through this connection (CFI > .95, GFI > .95, RMSEA = .01, SRMR = .08). Similar results were found in patients with breast-conserving surgery but with lower percentage (36%) of variance explained (CFI > .95, GFI > .95, RMSEA < .02, SRMR < .05). If confirmed by further studies, these results would suggest that patients who underwent mastectomy tend to be more dissatisfied with their body image, have tendency to perceive illness as threatening and resort to maladaptive coping styles. However, any form of appearance modification, including breast-conserving surgery, carries the risk of body image dissatisfaction, and consequently the risk of maladaptive coping behaviors. Our results suggest that health professionals and public policies should put an additional focus on the assessment of the patient's body image dissatisfaction, to improve the health and wellbeing of the affected women.