Losing the breast: A meta-synthesis of the impact in women breast cancer survivors.

Objectives: To summarise qualitative studies exploring the impact of losing the breast in women breast cancer survivors.

Methods: We identify, appraise, and synthesise 12 qualitative studies from 2000 to 2015. Quality appraisal of the studies was examined using the Critical Appraisal Skill Programme Checklist and Sandelowski and Barroso's step to synthesise the findings.

Results: The age of women in these studies ranged from 30 to 77 years. Losing the breast was regarded as disfigurement resulting in a discrepancy between self and societal image of a woman. Two themes were identified: (1) changes in identity and (2) coping with the changes in identity. The findings showed that women breast cancer survivors experienced both negative and positive impact of losing the breast; however, women were able to cope the changes in identity and live with the discrepancy.

Conclusions: The perceptions of losing the breast were filled with contradictions, tensions, and uncertainties while negotiating the discrepancy between the "self and body" and the societal expectations of femininity and womanhood. There is a need to develop personalised care plan for women who are going for mastectomy who may have high risk of developing negative perceptions of losing the breast and continue to support those women who have more positive perceptions of losing the breast.