THE IMPACT OF BREAST CANCER ON WOMEN'S BODY IMAGE AND SEXUAL FUNCTIONING

This research examined the impact of breast cancer on body image and sexual functioning. Twenty women who underwent a mastectomy, twenty-one women who underwent a lumpectomy, and twenty-one women without personal history of breast disease or surgery completed measures of life experiences, marital satisfaction, body satisfaction, and sexual functioning. Data was both retrospective and prospective. The prospective data was collected in the form of daily diary ratings of body satisfaction and sexual functioning, which all participants completed for one month. Contrary to expectation, body satisfaction and sexual functioning did not differ between groups. For all groups, body satisfaction increased over ~ime, and sexual functioning declined over time. Body image and sexual functioning items were reliably related for a few women in all three groups. Overall, results suggest that women adjust well to the consequences of breast cancer, and that after one year postsurgery, there are no major body image or sexual functioning difficulties. Acknowledgement This project represents much to me. First, it is the culmination of years of hard work on my part. Without the overwhelming support and influence of many individuals, however, I doubt I would have had the courage to persevere with this project or my career goals. I extend a heartfelt thank you to my parents, whose encouragement and faith allowed me to pursue my dream of becoming a clinical psychologist. I know my father would have preferred I become a physician or financial analyst, but he nonetheless supported my endeavors. I think that this has been very challenging for him at times! My mother's interest in my training and eagerness to listen to my woes has helped me immensely along the way. To my sisters, Debi and Cheryl, I am also thankful. They have always believed in me. I am extraordinarily grateful to my fiance, Edward Daniels, who has offered his humor, encouragement, and assistance in abundance. I am in awe of his patience. He has changed my life in valuable ways and is helping me to develop into the person I am becoming. My major professor, Dr. Patricia Morokoff, has taught me to persevere through challenges and to organize my thinki 'i1g in a clear manner. Further, it has been my good fortune to have wonderful committee members. Dr. Denise DeZol t, my former clinical supervisor, has taught me the importance of relationships in my clinical work. I shall always remember Dr. iii Janet Hirsch's contributions to my research, including her accompanying me to a physician's office to discuss my project with him. Dr. Winnie Brownell's interest in my work has meant an enormous amount to me. Because of her efforts, . the University awarded me funding to attend a Los Angelos conference to present my research in August, 1994. Without her rallying for me, I would not have been able to attend the conference. I also appreciate Dr. Quina' s willingness to participate in my dissertation defense. I first met her in 1989, before I came to URI, and hoped one day I would be able to work with her. Dr. Joan Chrisler was not an official committee member but deserves recognition. She has been a mentor to me and a consistent and strong source of encouragement for seven years. This section would not be complete without a sp~cial thank you to my grandparents, both of whom have nurtured my pursuits every step along the way. My grandmother, a breast cancer survivor, has been an inspiration for me personally, and her experience with breast cancer prompted my interest in this disease. To the breast cancer survivors involved in this research, I am indebted. Their participation made this research possible. I learned much from them.

In modern day society, attention to breasts is everywhere: in films, videos, and magazines; on posters and billboards; and in stores, schools, and offices (Wear, 1993).
Women's bodies are objectified (Meyerowitz, 1981), and women are trained to believe that their femininity rests on their being "double breasted and protruding" (Witkin, 1975, p. 303).

Goin
Time Post-surgery The mean number of years post-surgery was 6.7 years for women who had a mastectomy and 3.1 years for women who had a    Preference to Wear Clothing During Sexual Activity number of days women indicated they had oral sex, number of days breast stimulation was reportedly part of their sexual activity, and (8) the number of orgasms they indicated they had over the one month period of time.
(See Table  5.) This data was analyzed by obtaining the average for each (See Table  6).
18. Please gaze In a full length mirror at your entire clothed body for 30 seconds. Rate your level of satisfaction today with your body on a 1cale from A (not at all) to E (extremely satisfied). I bave been asked to take part In a research project described below. Tbe researcher will explain tbe project to me In detail. I should feel free to ask questions. U I bave more questions later, Elayne A. Saltzberg, M.A., the person mainly responsible for this study, (401-712-6182), will discuss them wltb me.
I have been asked to take part In a study of women's attitudes toward their bodies and sexual functioning. Tbe goal of the research is to learn more about bow women wbo have bad br~ast cancer feel about their bodies aud about sexual activities. It Involves women who have bad breast cancer answering questions oa these topics.
If I decide to take part la this study, here is what wlll bappen: Tbere are two parts to this research, both of which Involve answering questionnaires. First, I wlll complete a set of questionnaires. These questionnaires contain questions about body Image and sexual activities and take about one hour to complete. Thea, I wlll keep a short dally record for one mouth. This record Is la a checklist format and Includes questions on body Image and sexual activities. It should take about 5 minutes or less per day to complete. I will be paid S15.00 at tbe end of the study for my participation.
For some people, answering tbese questions may potentially be embarrassing and cause feelings of discomfort due to the personal nature of the questions. Elayne A. ·saltzberg, M.A., the principal researcber, will be available to me If I would like to discuss these feelings with her. She will also provide a list or resources or other professionals with whom I could discuss my feelings. Although there will be no direct benefit to me for taking part in this study, tbe researcher may learn more about bow women who bave bad breast cancer feel about their bodies and about sexuality.
My part ia this study is confidential. None or the Information wlll identify me by name. I will be assigned an identification number. This number wlll be on all or my questionnaires. No questionnaires, except the consent form, will have my name attacbed. A list will be kept separately with all of tbe participants' names and identification numbers. All records, including the list with my name and Identification number, will be kept in a locked file, to which only the researcher bas access.
If this study causes me any Injury, I should write or call the office of the Vice Provost for Research, 70 Lower College Road, University of Rhode Island, Kingston, Rhode Island, telephone: ( 40 l) 792-2635.
The decision wbetber or not to take part ia this study is up to me. I do not bave to participate. U I decide lo take part in the study, I may quit at any time. Whatever I decide will in no way penalize me. U I wish to quit I simply inform Elayne A. Saltzberg, M.A. at 782-6182 or my decision.
U I am not satisfied with the way tbis study is performed, I may discuss my complaints with Elayne A. Saltzberg, M.A. or with Patricia Morokorr, Ph.D., at (401)