當前社會文化脈絡所建構女人標準的身體，人們賦予乳房的意義深受社會價值與文化規範的影響，因此女人的身體總被視之為客體看待或予之評價，無形中加深乳癌婦女面對切除手術的困境。本研究目的在探討接受不同乳癌手術患者身體被物化程度對其身體心像與心理健康的影響，同時檢視配偶設身處地的同理與婦女自我概念及憂鬱的關係，並建立乳癌手術後婦女身體心像改變對其心理健康影響的初步模式。博士生以橫斷性的研究設計，自南部兩家醫學中心進行收案，共201位，其中接受乳房全切除者108位，佔53.7％，接受乳房保留手術者55位，佔27.4％，接受乳房切除合併重建者38位，佔18.9％。
研究結果發現：手術方式對身體心像與身體被物化程度有影響，其中接受乳房保留手術婦女的身體心像顯著優於乳房切除手術者，接受乳房重建手術者的身體監測與身體羞愧程度顯著高於接受其他兩種手術者。然而，三組憂鬱總分平均值，或是各組憂鬱人數比例，皆顯示不同手術的憂鬱症狀無顯著差異。同時，不同手術的自我概念亦未達顯著差異。此外，研究發現伴侶設身處地的同理能調節身體心像對憂鬱之影響。
結構方程模式經標準化分析發現，物化身體對身體心像的直接影響為0.73，身體心像對憂鬱的直接影響為0.67，而伴侶設身處地的同理對憂鬱亦存在直接作用，其影響為-0.32，整體而言，三項變項--物化身體、身體心像與伴侶設身處地的同理對憂鬱的解釋能力約56％。此外，在測量模式恆等進行多群組分析的情況下，本研究發現手術差異會干擾身體心像對憂鬱的影響。
本研究結果從人文社會的角度關懷乳癌婦女之身體經驗，進而從婦女的身體經驗瞭解其心理健康。研究所建構的模式可提供醫療照護人員設計促進乳癌婦女心理健康活動的省思，進而協助婦女正向看待接受乳癌手術後的身體，避免視其身體為物化的對象。

Background: The social and cultural antecedents that regard breasts as “objects” strongly influence the perspectives for women facing breast cancer. The purpose of this study is to explore the relationship between objectified body consciousness, body image and mental health among breast cancer women experiencing different surgeries. Empathy from women’s partners were also examined in the study. Structural equation model was used to establish the preliminary causal relationship between the variables. Method: Cross-sectional and correlation design with convenience sampling was used in this study. Permission to carry out the study had been received from a university ethics committee. Women agreed to participate in our study were given and signed the informed consent. Structured questionnaires measuring objectified body consciousness, body image, self/ other dyadic perspective taking, self-concept and depression were given to women treated with different breast cancer surgeries. Results: Two hundred and one women in which 108 receiving mastectomy, 55 receiving breast conservative surgery and 38 receiving mastectomy plus reconstruction recruited in this study. Results showed that women with different surgeries did not differ in their body image and depression (p>.05). However, women with breast reconstruction had higher objectified body consciousness score than the other surgery groups (p<.05). Partners’ perspective-taking was also a moderator between body image and depression. Modeling results indicated a strong association between body image and depression (r=.0.67) and between objectified body consciousness and body image (r=0.73), with weaker relationships between partners’ perspectives and depression (r=-0.32). Based on the measurement equivalent model, the differences only occurred on the degree of relationship between women receiving breast conservative surgery and mastectomy; however, the structural model was invariant, suggesting that the relationships among these variables may be similar for three groups. Conclusion: The conclusion from the causal equation model serves as a basis for health professionals to take account of social and cultural contexts when providing supports for women with breast cancer. Health care providers need to develop interventions that can cultivate the positive attitude for these women and prevent them from thinking their bodies as “object”.

中文部分
中華民國乳癌病友協會(2006)•陽光下的少奶奶依然美麗乳癌病友支持團體角色與功能問卷調查成果發表記者會二--身體形象與人際關係調查報告• 2007年3月1日取自http://www.tbca-npo.org.tw/toknow_info_data.php?idx=6。
王楚君（2003）•乳房手術患者術後二週內之症狀困擾、身體心像、生活品質之探討•未發表的碩士論文，台北：台北醫學大學。
行政院衛生署國民健康局(2006)•93年乳癌期別資料出爐了•2010年6月10日取自http://www.bhp.doh.gov.tw/download/themeParkId=510/960305/pdf/951220.pdf
行政院衛生署國民健康局(2010)•癌症登記年報•2010年6月9日取自http://www.bhp.doh.gov.tw/DOWNLOAD/Statistics/1.癌症登記年度報告（全）(92年以後資料僅含侵襲癌)/Y96-癌症登記年度報告（全).pdf
何定照譯(2007)•像女孩那樣丟球：論女性身體經驗•台北：商周。
何穎怡譯(2002)•乳房的歷史•台北：先覺。
林幸台、張小鳳、陳美光(2000)•田納西自我概念量表指導手冊。臺北: 測驗出版社。
侯明鋒、陳芳銘、歐陽賦(2008) • 乳癌手術的沿革•中華民國癌症醫學會雜誌，24(2)，102-107。
胡志家(2005)•憂鬱傾性、親密關係與乳癌術後婦女身體意像關係之探討。未發表的碩士論文，高雄：高雄醫學大學。
許素卿(2005)•心靈小棧對改善乳癌手術婦女身體心像及情緒狀態之成效•未發表的碩士論文，高雄：高雄醫學大學。
郭文宏、張金堅(1999)•乳癌治療新趨勢•當代醫學，26(12)，970-973。
郭文宏、張金堅(2006)•乳癌•台灣醫學，10(4)，475-481。
陳志梧譯 (1992)•看的方法 : 繪畫與社會關係七講•臺北: 明文書局。
陳海焦(1995)•乳癌婦女接受乳房切除手術後身體改變的經驗•未發表的碩士論文，台北：陽明大學。
曾光毅、李福春(2000)•現階段的乳癌預防與治療•基層醫學，15(6)，115-119。
楊榮宗(2003)•云想衣裳：女性乳癌患者與社會性別演出、身體意象•台灣社會研究季刊，49，49-95。
趙景雲(2005)•共謀或抵抗？瘦身女性身體的主體性與客體性 未發表之碩士論文。
鍾美玲、顧乃平、吳肖琪、趙祖怡＆陽琪(2001)•乳癌婦女治療後婚姻調適及其相關因素探討•護理雜誌，9(2)，137-146。
英文部分
Alderman, A. K. (2006). Use of breast reconstruction after mastectomy following the women’s health and cancer rights act. JAMA, 295(4), 387-388.
Al-Ghazal, S. K., Sully, L., Fallowfield, L., & Blamey, R. W. (2000). The psychological impact of immediate rather than delayed breast reconstruction. European Journal of Surgical Oncology, 26, 17-19.
Arora, N. K., Gustafson, D. H., Hawkins, R. P., McTavish, F., Cella, D. F., & Pingree, S., et al. (2001). Impact of surgery and chemotherapy on the quality of life of younger women with breast cancer. Cancer, 92, 1288-1298.
Avis, N. E., Crawford, S., & Manuel, J. (2005). Quality of life among younger women with breast cancer. Journal of Clinical Oncology, 23, 3322-3330.
Bagozzi, R. P & Yi, Y. (1988). On the evaluation of structural equation models, Academic of Marketing Science, 16 74-94.
Baider, L., Rizel, s. & de-Nour, A. K. (1986). Comparison of couple’s adjustment to lumpectomy and mastectomy. General Hospital Psychiatry, 8, 251-257.
Bartky, S. L. (1990). Femininity and domination: Studies in the phenomenology of oppression. New York: Routledge.
Baucom, D. H., Porter, L. S., Kirby, J. S., Gremore, T. M., & Keefe, F. J. (2006). Psychological issues confronting young women with breast cancer. Breast Disease, 23, 103-113.
Bay-Cheng, L. Y., Zucker, A. N., Stewart, A. J., & Pomerleau, C. S. (2002). Linking femininity, weight concern, and mental health among Latina, Black, and White women. Psychology of Women Quarterly, 26(1), 36-45.
Bond, M. H. (1986). The psychology of Chinese people. Oxford: Oxford University Press. Burbie, G. E. & Polinsky.
Bower, J. E.,Ganz, P.A., Desmond, K. A., Rowland, J. H., Meyerowitz, B. E., & Belin, T. R. (2000). Fatigue in breast cancer survivors: Occurrence correlates and impact on quality of life. Journal of Clinical Oncology, 18(4), 743-753.
Bredin, M. (1999). Mastectomy, body image and therapeutic massage: A qualitative study of women’s experience. Journal of Advanced Nursing, 29(5), 1113-1120.
Brower, E. I. (2003). The role of the complexity of women’s self-concepts in the prediction of the importance of body image in adjustment to mastectomy with and without reconstruction. Unpublished Doctoral Dissertation.
Burgess C, Cornelius V, Love S, Graham J, Richards M, Ramirez A. (2005). Depression and anxiety in women with early breast cancer: five year observational cohort study. BMJ, 330(7493), 702-705.
Burwell, S. R., Case, L. D., Kaelin, C., & Avis, N. E. (2006). Sexual problems in younger women after breast cancer surgery. J Clin Oncol, 24(18), 2815-2821.
Buss, D. M., Abbott, M., Angleitner, A., Asherian, A., Biaggio, A. & Blanco-Villasenor, A. et al. (1990). International preferences in selecting mates. Journal of Cross-Cultural Psychology, 21, 5-47.
Carver, C. S., Pozo-Kaderman, C., Price, A. A., Noriega, V., Harris, S. D., Derhagopian, R. P., Robison, D. S., & Moffatt, F, L. (1998). Concern about aspects of body image and adjustment to early stage breast cancer. Psychosomatic Medicine, 60(2), 168-174.
Cash, T. F., & Fleming, E. C. (2004). Body image and social relations. In In T.F. Cash & T. Pruzinsky (Ed.). Body Image: A hand book of theory, research, and clinical practice (pp. 277-286). New York: The Guilford Press.
Chang, H. & Holt, G. R. (1991). The concept of yuan and Chinese interpersonal relationship, In: S, Ting-Toomey & F. Korzenny (Eds), Cross-curtural interpersonal communication (pp. 28-57). Newbury Park, CA: Sage.
Chang, J. T., Chen, C. J., Lin, Y. C., Chen, Y. C., Lin, C. Y., & Cheng, A. J. (2007). Health-related quality of life and patient satisfaction after treatment for breast cancer in northern Taiwan. Int J Radiat Oncol Biol Phys, 69(1), 49-53.
Chen, X., Zheng, Y., Zheng, W., Gu, K., Chen, Z., Lu, W., et al. (2009). Prevalence of depression and its related factors among Chinese women with breast cancer. Acta Oncol, 48(8), 1128-1136.
Chien C. P. & Cheng T. A. (1985). Depression in Taiwan: epidemiological survey utilizing CES-D. Bulletin of Japanese Society of Neurology and Psychiatry, 87, 335-338.
Christensen, S., Zachariae, R., Jensen, A. B., Vaeth, M., Moller, S., Ravnsbaek, J., et al. (2009). Prevalence and risk of depressive symptoms 3-4 months post-surgery in a nationwide cohort study of Danish women treated for early stage breast-cancer. Breast Cancer Res Treat, 113(2), 339-355.
Christian, C. K., Niland, J., Edge, S. B., Ottesen, R. A., Hughes, M. E., Theriault, R., et al. (2006). A multi-institutional analysis of the socioeconomic determinants of breast reconstruction: a study of the National Comprehensive Cancer Network. Ann Surg, 243(2), 241-249.
Cimprich, B., Ronis, D. L., & Martinze-Ramos, G. (2002). Age at diagnosis and quality of life in breast cancer survivors. Cancer Practice, 10, 85-93.
Clough-Gorr, K. M., Ganz, P. A., & Silliman, R. A. (2007). Older breast cancer survivors: factors associated with change in emotional well-being. J Clin Oncol, 25(11), 1334-1340.
Cohen, J. (1977). Statistical power analysis for the behavioral sciences (revised edition). New York: Academic Press.
Contant, C. M. E., Wersch, A.M.E., Menke-Pluymers, M.B. E.,Tjong Joe Wai, R., Eggermont, A. M. M. & van Geel, A. N. (2004). Satisfaction and prosthesis related complaints in women with immediate breast reconstruction following prophylactic and oncological mastectomy. Psychology, Health and Medicine, 9(1), 71-84.
Coopersmith, S. (1967). The Antecedents of Self Esteem, W. H. Freeman, San Francisco.
Cotlar, C. A. M., Dubose, C. J. J., & Rose, M. D. M. (2003). History of Surgery for Breast Cancer: Radical to the Sublime. Current Surgery, 60(3), 329-337.
Covich, J. L. (1999). The relationship between breast reconstruction and psychological adjustment when a mastectomy is necessary. Unpublished doctoral dissertation, University of Texas at Austin.
Coyne, J. C., & Anderson, K. K. (1999). Marital status, marital satisfaction, and support process among women at high risk for breast cancer: comparing African Americans, Hispanics, and non-Hispanic Whites. Psycho-Oncology, 11, 495-504.
Crompvoets, S. (2006). Comfort, Control, or Conformity: Women who choose breast reconstruction following mastectomy. Health Care for Women International, 27, 75-93.
Davis, C. & Katzman, M. (1997). Charting new territory: Body esteem, weight satisfaction, depression, and self-esteem among Chinese males and females in Hong Kong. Sex Roles, 36, 449-459.
Dean, C., Chetty, U., & Forrest, A. P. (1983). Effects of immediate breast reconstruction on psychological morbidity after mastectomy. Lancet, 26, 459-462.
Den Oudsten, B. L., Van Heck, G. L., Van der Steeg, A. F., Roukema, J. A., & De Vries, J. (2009). Predictors of depressive symptoms 12 months after surgical treatment of early-stage breast cancer. Psychooncology, 18(11), 1230-1237.
Deutsch, H. (1942). Some psychoanalytic observations in surgery. Psychosomatic Medicine, 4, 105-115.
Dian, D., Schwenn, K., Mylonas, I., Janni, W., Friese, K., & Jaenicke, F. (2007). Quality of life among breast cancer patients undergoing autologous breast reconstruction versus breast conserving therapy. J Cancer Res Clin Oncol, 133(4), 247-252.
Dorval, M., Maunsell, E., Deschenes, L., & Brisson, J. (1998). Type of mastectomy and quality of life for long term breast carcinoma survivors. Cancer, 83, 2130-2138.
Dorval, M., Maunsell, E., Deschenes, L., Brisson, J., & Masse, B. (1998). Long-term quality of life after breast cancer: comparison of 8-year survivors with population controls. J Clin Oncol, 16(2), 487-494.
Fang, S, Y., Balneaves, G. L., & Shu, B. C. (2010). A struggle between vanity and life: The experience of women receiving breast reconstruction in Taiwan. Cancer Nursing (In press)
Fang, S, Y., & Shu, B. C. & Fezer, S. (2010). Deliberating over mastectomy: survival and social roles. Cancer Nursing (Accepted)
Fang, S, Y., & Shu, B. C. (2009). Adherence characteristics after abnormal screening results between Mammogram and Papanicolaou test groups. Cancer Nursing, 32(6)437~45.
Figueiredo, M. I., Cullen, J., Hwang, Y. T., Rowland, J. H., & Mandelblatt, J. S. (2004). Breast cancer treatment in older women: does getting what you want improve your long-term body image and mental health? J Clin Oncol, 22(19), 4002-4009.
Fobair, P., Stewart, S. L., Chang, S., D'Onofrio, C., Banks, P. J., & Bloom, J. R. (2006). Body image and sexual problems in young women with breast cancer. Psycho-oncology, 15(7), 579-594.
Fortz, A. T. (1987). The influence of cancer on self-concept and life quality. Seminars in Oncology Nursing, 3(4), 303-312.
Fredrickson, B. & Robert, T. (1997). Objectification theory: Toward understanding women’s lived experiences and mental health risks. Psychology of Women Quarterly, 21, 173-206.
Fredrickson, B. & Robert, T., Noll, S. M., Quinn, D. M. and Twenge, J. M. (1998). That swimsuit becomes you: sex differences in self-objectification, restrained eating, and math performance. Journal of Personality and Social Psychology, 75, 269-284.
Friedman, M. A., Dixon, A. E., Brownell, K. D., Whisman, M. A., & Wilfley, D. E. (1999). Marital status, marital satisfaction, and body image dissatisfaction. Int J Eat Disord, 26(1), 81-85.
Fung, KW., Lau, Y., & Fielding, R., Or, A., & Yip, A.W. (2001). The impact of mastectomy, breast-conserving treatment and immediate breast reconstruction on the quality of life of Chinese women. ANZ Journal of Surgery. 71(4):202-6.
Ganz, P. A., Guadagnoli, E. Landrum, M. B., Lash, T. L., Rakowski, W. & Silliman, R. A. (2003). Breast cancer in older women: Quality of life and psychosocial adjustment in the 15 months after diagnosis. Journal of Clinical Oncology, 21(21), 4027-4033.
Ganz, P. A., Rowland, J. H., Desmond, K. A., Meyerowitz, B. E., & Wyatt, G. E. (1998). Life after breast cancer: Understanding women’s health-related quality of life and sexual functioning. Journal of Clinical Oncology, 16, 504-514.
Ghizzani, A., Pirtoli, L., Bellezza, A., & Velicogna, F. (1995). The evaluation of some factors influencing the sexual life of women affected by breast cancer. J Sex Marital Ther, 21(1), 57-63.
Giese-Davis, J. Hermanson, K., Koopman, C., Weibel, D., & Spiegel, D. (2000). Quality of couples’ relationship and adjustment to metastatic breast cancer. Journal of Family Psychology, 14(2), 251-266.
Gilligan, C. (1982). In a Different Voice: psychological theory and women's development. Cambridge, MA: Harvard University Press.
Grippo, K. P., & Hill, M. S. (2008). Self-objectification, habitual body monitoring, and body dissatisfaction in older European American women: exploring age and feminism as moderators. Body Image, 5(2), 173-182.
Hair, J. F., Black, B. Babin, B., Anderson, R. E., & Tatham, R. L. (2005). Multivariate Data Analysis, 6th ed. Prentice-Hall.
Hall, S. E., & Holman, C. D. (2003). Inequalities in breast cancer reconstructive surgery according to social and locational status in western Australia. European Journal of Surgical Oncology, 29, 519-525.
Harcourt, D. M., Rumsey, N. J., Ambler, N. R., Cawthorn, S. J., Reid, C. D., Maddox, P. R., et al. (2003). The psychological effect of mastectomy with or without breast reconstruction: a prospective, multicenter study. Plast Reconstr Surg, 111(3), 1060-1068.
Hart, S. L., Latini, D. M., Cowan, J. E., & Carroll, P. R. (2008). Fear of recurrence, treatment satisfaction, and quality of life after radical prostatectomy for prostate cancer. Support Care Cancer, 16(2), 161-169.
Hartl, K., Janni, W., Kastner, R., Sommer, H., Strobl, B., & Stauber, M. (2003). Impact of medical and demographic factors on long-term quality of life and body image of breast cancer. Annals of Oncology, 14(7), 1064-1071.
Hegel, M. T., Moore, C. P., Collins, E. D., Kearing, S., Gillock, K. L., Riggs, R. L., Clay, K. F., & Ahles, T. A. (2006). Distress, psychiatric syndromes, and impairment of function in women with newly diagnosed breast cancer. Cancer, 107(12), 2924-31.
Helms, R. L., O'Hea, E. L., & Corso, M. (2008). Body image issues in women with breast cancer. Psychol Health Med, 13(3), 313-325.
Henderson, I. C. (1995). Paradigmatic shifts in the management of breast cancer. New England Journal of Medicine, 332, 951-952.
Himelein, M. J., & Thatcher, S. S. (2006). Depression and body image among women with polycystic ovary syndrome. Journal of Health Psychology, 11(4), 613-625.
Holmberg, S. K., Scott, L. L., Alexy, W., & Fife, B. L. (2001). Relationship issues of women with breast cancer. Cancer Nursing, 24(1), 53-60.
Hopwood, P., Fletcher, I., Lee, A., & Al Ghazal, S. (2001). A body image scale for use with cancer patients. European Journal of Cancer, 37(2), 189-97.
Hopwood, P., Haviland, J., Mills, J., Sumo, G., & Bliss, J. M. (2007). The impact of age and clinical factors on quality of life in early breast cancer: an analysis of 2208 women recruited to the UK START Trial (Standardisation of Breast Radiotherapy Trial). Breast, 16(3), 241-251.
Hopwood, P., Lee, A., Shenton, A., Baildam, A., Brain, A., Lalloo, F., et al. (2000). Clinical follow-up after bilateral risk reducing ('prophylactic') mastectomy: mental health and body image outcomes. Psycho-oncology, 9(6), 462-472.
Hopwood, P., Sumo, G., Mills, J., Haviland, J., Bliss, J. M., & On Behalf Of The Start Trials Management, G. (2009). The course of anxiety and depression over 5 years of follow-up and risk factors in women with early breast cancer: Results from the UK Standardisation of Radiotherapy Trials (START). Breast. DOI: S0960-9776(09)00170-2 [pii] 10.1016/j.breast.2009.11.007
Irwig, L., & Bennetts, A. (1997). Quality of life after breast conservation or mastectomy: a systematic review. Aust N Z J Surg, 67(11), 750-754.
Janz, N. K., Mujahid, M., Lantz, P. M., Fagerlin, A., Salem, B., Morrow, M., et al. (2005). Population-based study of the relationship of treatment and sociodemographics on quality of life for early stage breast cancer. Qual Life Res, 14(6), 1467-1479.
Johson, R. J. (1994). Caring for the women who’s had a mastectomy. American Journal of Nursing, 94(5), 25-31.
Jordan, J. V., Kaplan, A. G., Miller, J. B., Stiver, I. P., Suney, I. P., & Surrey, J. L. (1991). Women’s Growth in Connection. New York: The Guiford Press.
Kalaitzi, C., Papadopoulos, V. P., Michas, K., Vlasis, K., Skandalakis, P., & Filippou, D. (2007). Combined brief psychosexual intervention after mastectomy: Effects on sexuality, body image, and psychological well-being. Journal of Surgical Oncology, 96, 235-240.
Kasper, A. S. (1995). The social construction of breast loss and reconstruction. Women’s Health, 1(3), 197-219.
Keating, N. L., Guadagnoli, E., Landrum, M. B., Borbas, C., & Weeks, J. C. (2002). Treatment decision making in early-stage breast cancer: should surgeons match patients' desired level of involvement? J Clin Oncol, 20(6), 1473-1479.
Kilbourne, J. (1994). Still Killing us softly: Advertising and the obsession with thinness. In P. Fallon, M. A. Katzman, & S. C. Wooley (Eds), Feminist perspectives on eating disorders (pp. 395-418). New York: Guilford Press.
Killoran, M. & Moyer, A. (2006). Surgical treatment preferences in Chinese-American women with early-stage breast cancer. Psycho-Oncology, 15, 969-984.
Kim, S. H., Son, B. H., Hwang, S. Y., Han, W., Yang, J. H., Lee, S., & Yun, Y. H. (2008). Fatigue and Depression in Disease-Free Breast Cancer Survivors: Prevalence, Correlates, and Association with Quality of Life. Journal of Pain and symptom Management. doi:10.1016/j.jpainsymman.2007.08.012
King, M. T., Kenny, P., Shiell, A., Hall, J., & Boyages, J. (2000). Quality of life three months and one year after first treatment for early stage breast cancer: influence of treatment and patient characteristics. Qual Life Res, 9(7), 789-800.
Lai, A. (2006). Eye on religion: cultural signs and caring for Chinese patients. South Med J, 99(6), 688-689.
Lam WW, Fielding R, Chan M, Chow L, Or A. (2005). Gambling with your life: the process of breast cancer treatment decision making in Chinese women. Psycho-oncology, 14, 1-15.
Lam, W. W. T., & Fielding, R. & Ho, E. Y. Y. (2004). Predicting psychological morbidity Chinese women after surgery for breast carcinoma. Cancer, 103(3), 637–646.
Lam, W. W. T., & Fielding, R. (2003). The evolving experience of illness for Chinese women with breast cancer: A qualitative study. Psycho-Oncology, 12, 127–140.
Lantz, P. M., Janz, N. K., Fagerlin, A., Schwartz, K., Liu, L., Lakhani, I., et al. (2005). Satisfaction with surgery outcomes and the decision process in a population-based sample of women with breast cancer. Health Serv Res, 40(3), 745-767.
Laster, J. & Fulton, J. S. (1998). Breast cancer: advances in diagnosis and surgical treatment. American Journal of Nursing, suppl, 8-11.
Lee, M. C., Rogers, K., Griffith, K., Diehl, K. A., Breslin, T. M., Cimmino, V. M., et al. (2009). Determinants of breast conservation rates: reasons for mastectomy at a comprehensive cancer center. Breast J, 15(1), 34-40.
Lewis, F. M., & Deal, L. W. (1995). Balancing our lives: a study of the married couple's experience with breast cancer recurrence. Oncol Nurs Forum, 22(6), 943-953.
Lichtman, R. R., Taylor, S. E., & Wood, J. V. (1987). Social support and marital adjustment after breast cancer. Journal of Psychosocial Oncology, 5(3), 47-74.
Lindberg, S. M., Hyde, J. S., & McKinley, N. M. (2006). A measure of objectified body consciousness for preadolescent and adolescent youth. Psychology of Women Quarterly, 30, 65-76.
Long, E. C. J. (1990). Measuring dyadic perspective-taking: Two scales for assessing perspective-taking in marriage and similar dyads. Educational and Psychological Measurement, 50, 91-103.
Lorde, A. (1980). The Cancer Journals. San Francisco, CA: Aunt Lute Books.
MacCallum, R.C., Browne, M.W., & Sugawara, H.M. (1996). “Power analysis and determination of sample size for covariance structure modeling”, Psychological Methods 1(2): 130-149.
Mak, V. (2002). Psychological predictors of marital adjustment in breast cancer patients. Psychology, Health and Medicine, 7(1), 37-51.
Manne, S. (1998). Cancer in the marital context: a review of the literature. Cancer Invest, 16(3), 188-202.
Manne, S. L., Ostroff, J. S., Norton, T. R., Fox, K., Goldstein, L., & Grana, G. (2006). Cancer-related relationship communication in couples coping with early stage breast cancer. Psychooncology, 15(3), 234-247.
Manne, S. L., Pape, S. J., Taylor, K. L., & Dougherty, J. (1999). Spouse support, coping, and mood among individuals with cancer. Ann Behav Med, 21(2), 111-121.
Markey, C. N., Markey, P. M., & Birch, L. L. (2004). Understanding women's body satisfaction: The role of husbands. Sex Roles, 51, 209–216.
McKinley, N. M. (1995). Women and objectified body consciousness: A feminist psychological analysis. (Doctoral dissertation, University of Wisconsin-Madison, Madison, WI, 1995). Dissertation Abstracts International, 56, 05B, 9527111.
McKinley, N. M. (1998). Gender differences in undergraduates' body esteem: The mediating effect of objectified body consciousness and actual/ideal weight discrepancy. Sex Roles, 39(1-2), 113-123.
McKinley, N. M. (1999). Women and objectified body consciousness: Mothers’ and daughters’ body experience in cultural, development and familial context. Developmental Psychology, 35, 760-769.
Mckinley, N. M. (2004). Feminist perspectives and objectified body consciousness. In T. F. Cash & T. Pruzinsky (Ed.), Body Image: A handbook of theory, research, and clinical practice (pp55-62). New York: The Guilford Press.
McKinley, N. M., & Hyde, J. S. (1996). The objectified body consciousness scale: Development and validation. Psychology of Women Quarterly, 20, 181-215.
McKinley, N. M., & Lyon, L. A. (2008). Menopausal attitudes, objectified body consciousness, aging anxiety, and body esteem: European American women's body experiences in midlife. Body Image, 5(4), 375-380.
Mitchell, K. S., & Mazzeo, S. E. (2009). Evaluation of a Structural Model of Objectification Theory and Eating Disorder Symptomatology among European American and African American Undergraduate Women. Psychology of Women Quarterly, 33(4), 384-395.
Mock V. (1993). Body image in women treated for breast cancer. Nursing Research. 42(3):153-7.
Moreira, H., Silva, S., Marques, A., & Canavarro, M. C. (2010). The Portuguese version of the Body Image Scale (BIS) - psychometric properties in a sample of breast cancer patients. Eur J Oncol Nurs, 14(2), 111-118.
Morris, C. R., Cohen, R., Schlag, R., Wright, W. E. (2000). Increasing trends in the use of breast-conserving surgery in California. American Journal of Pubic Health, 90, 281-284.
Moyer, A. (1997). Psychosocial outcomes of breast-conserving surgery versus mastectomy: a meta-analytic review. Health Psychol, 16(3), 284-298.
Muehlenkamp, J. J., & Saris-Baglama, R. N. (2002). Self-objectification and its psychological outcomes for college women. Psychology of Women Quarterly, 26, 371-379.
Nano, M.T., Gill, P. G., Kollias, J., Bochner, M.A., Malycha, P., & Winefield, H.R. (2005). Psychological impact and cosmetic outcome of surgical breast cancer strategies. AZN Journal of Surgery, 75, 940-947.
Nicholson, R. M., Leinster, S. & Sassoon, E. M. (2007). A comparison of the cosmetic and psychological outcome of breast reconstruction, breast conserving surgery and mastectomy without reconstruction. The Breast, 16, 396-410.
Nissen, M. J., Swenson, K. K., & Kind, E. A. (2002). Quality of life after postmastectomy breast reconstruction. Oncol Nurs Forum, 29(3), 547-553.
Noll, S. M. (1997). The relationship between sexual objectification and disordered eating: Correlational and experimental tests of body shame as a mediator. Doctoral dissertation, Duke University, Durham, NC. Disseration Abstracts International, 57,09B,9704732.
Northouse, L. L. (1988). Social support in patients’ and husbands’ adjustment to breast cancer. Nursing Research, 37(2), 91-95.
Northouse, L. L., Templin, T., Mood, D., & Oberst, M. (1998). Couples' adjustment to breast cancer and benign breast disease: a longitudinal analysis. Psychooncology, 7(1), 37-48.
Norton, T. R., Manne, S. L., Rubin, S., Hernandez, E., Carlson, J., Bergman, C., et al. (2005). Ovarian cancer patients' psychological distress: the role of physical impairment, perceived unsupportive family and friend behaviors, perceived control, and self-esteem. Health Psychol, 24(2), 143-152.
O’Mahoney, J. M., & Carroll, R. A. (1997). The impact of breast cancer and its treatment on marital functioning. Journal of Clinical Psychology in Medical Setting, 4(4), 397-415.
Ohsumi, S., Shimozuma, K., Kuroi, K., Ono, M., & Imai, H. (2007). Quality of life of breast cancer patients and types of surgery for breast cancer--current status and unresolved issues. Breast Cancer, 14(1), 66-73.
Omne-Ponten, M., Holmberg, L., Burns, T., Adami, H. O., & Bergstrom, R. (1992). Determinants of the psycho-social outcome after operation for breast cancer. Results of a prospective comparative interview study following mastectomy and breast conservation. Eur J Cancer, 28A(6-7), 1062-1067.
Palmer, S. C., Kagee, A., Coyne, J. C., & DeMichele, A. (2004). Experience of trauma, distress, and posttraumatic stress disorder among breast cancer patients. Psychosomatic Medicine, 66(2), 258-64
Parker, P. A., Youssef, A., Walker, S., Basen-Engquist, K., Cohen, L., Gritz, E. R., Wei, QX., & Robb, G. L. (2007). Short-term and long-term psychosocial adjustment and quality of life in women undergoing different surgical procedures for breast cancer. Ann Surg Oncol. 14(11), 3078-89.
Pennington, D. G. (2005). Breast reconstruction after mastectomy: Current state of the art. ANZ Journal of Surgery, 75, 454-458.
Petronis, V. M., Carver, C. S., Antoni, M. H., & Weiss, S. (2003). Investment in body image and psychosocial well-being among women treated for early stage breast cancer: Partial replication and extension. Psychology & Health, 18, 1-13.
Pistrang, N. & Barker, C. (1995). The partner relationship in psychological response to breast cancer. Social Science and Medicine, 40(6), 789-797.
Pockaj, B. A., Degnim, A. C., Boughey, J. C., Gray, R. J., McLaughlin, S. A., Dueck, A. C., et al. (2009). Quality of life after breast cancer surgery: What have we learned and where should we go next? J Surg Oncol, 99(7), 447-455.
Polit, D. and Hungler, B. (1995). Nursing Research: Principles and Methods, 5th ed. J.B. Lippincott Company, Philadelphia, New York, Baltimore.
Polivy, J. (1977). Psychological effects of mastectomy on a woman's feminine self-concept. J Nerv Ment Dis, 164(2), 77-87.
Pozo, C., Carver, C. S., Noriega, V., Harris, S. D., Robinson, D. S., Ketcham, A. S., et al. (1992). Effects of mastectomy versus lumpectomy on emotional adjustment to breast cancer: a prospective study of the first year postsurgery. J Clin Oncol, 10(8), 1292-1298.
Prichard, I., & Tiggemann, M. (2005). Objectification in fitness centers: Self-objectification, body dissatisfaction, and disordered eating in aerobic instructors and aerobic participants. Sex Roles, 53(1-2), 19-28.
Reaby, L. L., Hort, L. K., & Vandervord, J. (1994). Body image, self-concept, and self-esteem in women who had a mastectomy and either wore an external breast prosthesis or had breast reconstruction and women who had not experienced mastectomy. Health Care Women Int, 15(5), 361-375.
Rosenbaum, M. E. (1994). Cultural analysis of women, breast cancer surgery and the meanings of breast. Unpublished Doctoral Dissertation.
Roth, R. S., Lowery, J. C., Davis, J., & Wilkins, E. G. (2005). Quality of life and affective distress in women seeking immediate versus delayed breast reconstruction after mastectomy for breast cancer. Plast Reconstr Surg, 116(4), 993-1002; discussion 1003-1005.
Rowland, J. H., Desmond, K. A., Meyerowitz, B. E., Belin, T. R., Wyatt, G. E., & Ganz, P. A. (2000). Role of breast reconstructive surgery in physical and emotional outcomes among breast cancer survivors. J Natl Cancer Inst, 92(17), 1422-1429.
Rutledge, D. N., & Raymon, N. J. (2001). Changes in well-being of women cancer survivors following a survivor weekend experience. Oncology Nursing Forum, 28(1), 85-91.
Sakorafas, G. H. (2001). Breast Cancer Surgery: History evolution, current status and future perspectives. Acta Oncologica, 40(1), 5-18.
Schain, W. S., Jacobs. E., & Wellish, D. K. (1984). Psychological issues in breast reconstruction: Intra-psychic, intra-personal., and practical concerns. Clinics in Plastic Surgery, 11, 237-252.
Schain, W. S., Wellisch, D. K., Pasnau, R. O., & Landsverk, J. (1985). The sooner the better: a study of psychological factors in women undergoing immediate versus delayed breast reconstruction. American Journal of Psychiatry, 142(1), 40-46.
Schou, I, Ekeberg, O., Ruland, C. M., Sandvik, L. & Karesen, R. (2004). Pessimism as a predictor of emotional morbidity one year following breast cancer surgery. Psycho-Oncology, 13, 309~320.
Schover, L. R.,Yetman, R. J., Tuason, L. J., Meisler, E., Esselstyn, C. B., Hermann, R. E., Grundfest-Broniatowski, S. Dowden, R. V. (1995). Partial mastectomy and breast reconstruction. A comparison of their effects on psychosocial adjustment, body image, and sexuality. Cancer. 75(1):54-64.
Scott, J. L., Halford, W. K., & Ward, B. (2004). United we stand? The effects of a couple-coping intervention on adjustment to breast or gynaecological cancer. Journal of Consulting and Clinical Psychology, 72, 1122-1135.
Simard, S., & Savard, J. (2009). Fear of Cancer Recurrence Inventory: development and initial validation of a multidimensional measure of fear of cancer recurrence. Support Care Cancer, 17(3), 241-251.
Sinclair, S. L. (2006). Object lesson: A theoretical and empirical study of objectified body consciousness in women. Journal of Mental Health Counseling, 28(1), 48-68.
Skerrett, K. (1998). Couple adjustment to the experience of breast cancer. Families, Systems & Health, 16, 281-298.
Slater, A., & Tiggemann, M. (2002). A test of objectification theory in adolescent girls. Sex Roles, 46, 343-349.
Spitzack, C. (1990). Confessing excess: Women and the politics of body reduction. Albany, NY: State University of New York Press.
Stice, E., Hayward, C., Cameron, R., Killen, J., & Taylor, C. (2000). Body image and eating disturbances predict onset of depression among female adolescents: A longitudinal study. Journal of Abnormal Psychology, 109, 438-444.
Takahashi, M., Ohno, S., Inoue, H., Kataoka, A., Yamaguchi, H., Uchida, Y., Oshima, A., Abiru, K., Ono, K., Noguchi, R.& Kai, I. (2007). Impact of breast cancer diagnosis and treatment on women's sexuality: a survey of Japanese patients. Psycho-Oncology. DOI:10.1002/pon.1297.
Tantleff-Dunn, S. & Thompson, J. K. (1995). Romantic partners and body image disturbance: Further evidence for the role of perceived-actual disparities. Sex Roles, 33(9-10), 589–605.
Taskila, T., & Lindbohm, M. L. (2007). Factors affecting cancer survivors' employment and work ability. Acta Oncol, 46(4), 446-451.
Taylor-Brown, J., Kilpatrick, M., Maunsell, E., Dorval, M. (2000). Partner abandonment of women with breast cancer. Myth or reality? Cancer Practice, 8(4), 160-4.
The Women’s Health Resource (2010). Breast cancer: Statistics on incidence, survival, and screening. The Women’s Health Resource Web site. http://www.imaginis.com/breast-health/breast-cancer-statistics-on-incidence-survival-and-screening-2#breast-cancer-cases-deaths-per-year-u-s-and-world. Accessed June 09, 2010.
Tiggemann, M., & Lynch, J. E. (2001). Body image across the life span in adult women: the role of self-objectification. Dev Psychol, 37(2), 243-253.
Tiggemann, M., & Slater, A. (2001). A test of objectification theory in former dancers and non-dancers. Psychol Women Quarterly, 25, 57-64.
Virnig B, Habermann E, Al-Refaie W, Jensen, E. & Tuttle, T. (2007). Increased use of breast-conserving surgery: Preferred treatment or failure to provide adequate local therapy? Breast Cancer Res Treat, 106s. abstract 4065.
Webster, J., & Tiggemann, M. (2003). The relationship between women's body satisfaction and self-image across the life span: the role of cognitive control. J Genet Psychol, 164(2), 241-252.
Weihs, K., Enright, T., Howe, G. & Simmens, S. J. (1999). Marital satisfaction and emotional adjustment after breast cancer. Journal of Psychosocial Oncology, 17(1), 33-49.
Wiederman, M. W. (2004). Body image and sexual functioning. In In T.F. Cash & T. Pruzinsky (Ed.). Body Image: A hand book of theory, research, and clinical practice (pp. 287-294). New York: The Guilford Press.
Wiederman, M. W., & Pryor, T. L. (2000). Body dissatisfaction, bulimia, and depression among women: the mediating role of drive for thinness. Int J Eat Disord, 27(1), 90-95.
Wimberly, S. R., Carver, C. S., Laurenceau, J. P. Harris, S. D., & Antoni, M. H. (2005). Perceived partner reactions to diagnosis and treatment of breast cancer: Impact on psychosocial and psychosexual adjustment. Journal of consulting and clinical psychology, 73(2), 300-311.
Winchester, D. P., Trabanino, L., & Lopez, M. J. (2005). The evolution of surgery for breast cancer. Surgical Oncology Clinics of North America, 14, 479-498.
Winder, A. E. & Winder, B. D. (1985). Patient counseling: Clarifying a woman’s choice for breast reconstruction. Patient Education and Counseling, 7, 65-75.
Yates, A., Edman, J., & Aruguete, M. (2004). Ethnic differences in BMI and body/self-dissatisfaction among Whites, Asian subgroups, Pacific Islanders, and African-Americans. J Adolesc Health, 34(4), 300-307.
Yurek, D. Farrar, W. Andersen, B. L. (2000). Breast cancer surgery: comparing surgical groups and determining individual differences in postoperative sexuality and body change stress. Journal of Consulting & Clinical Psychology. 68(4):697-709.
Zabora, J., BrintzenhofeSzoc, K., Curbow, B., Hooker, C., & Piantadosi, S. (2001). The prevalence of psychological distress by cancer site. Psycho-Oncology, 10(1), 19-28.