Psychological distress and body image disturbances among breast cancer survivors following modified radical mastectomy: a cross-sectional study at a tertiary care hospital

Background: Breast cancer is the most prevalent malignancy among women globally, with improved survival due to early diagnosis and treatment. However, survivors often face psychological distress and body image disturbances (BID) following mastectomy, chemotherapy-induced changes and societal perceptions. Despite increasing awareness, limited research has assessed the long-term psychosocial impact of breast cancer treatment, especially in Indian women. This study aimed to assess the prevalence of psychological distress and BID among breast cancer survivors who underwent modified radical mastectomy (MRM). Methods: A cross-sectional study was conducted at a tertiary care hospital in Maharashtra, India, involving 155 breast cancer survivors recruited through outpatient follow-ups and telephonic interviews. Participants were women aged 18–60 years who had completed treatment at least three months prior. Psychological distress was measured using the Depression, Anxiety and Stress Scale (DASS-21) and BID using the 10-item Body Image Scale. Statistical analysis included logistic regression for categorical data and t-tests for continuous variables, with p<0.05 as significant. Results: Depression was found in 72.5%, with mild (18.2%), moderate (4.7%), severe (3.8%) and very severe (1.8%) cases. Anxiety and stress were present in 29.7% and 24.9%, respectively. BID was reported in 53.6%. Fear of recurrence was noted in 98%, contributing to distress. Lower education, unemployment and postmenopausal status were associated with higher distress. Conclusions: High rates of psychological distress and BID post-MRM underscore the need for integrated mental health services in oncology care to improve survivors' quality of life.