Background
While positive body image is increasingly recognised as a protective factor for psychological well-being and quality of life following breast cancer diagnosis, existing research has largely focused on Western contexts. Less is known about how positive body image is understood and experienced in non-Western cultural settings. This study qualitatively explores how positive body image is constructed and understood by women with breast cancer in China and Australia.
Methods
One-on-one semi-structured interviews were conducted with 19 Chinese (aged 30–71) and 18 Australian (aged 40–74) breast cancer survivors, recruited from a larger study on body image. Interviews explored their post-treatment body image perceptions and factors shaping their understanding of positive body image. Interviews were transcribed verbatim, with Chinese interviews translated into English by a bilingual researcher (XH). Data were analysed using reflexive thematic analysis, with four transcripts (2 Australian, 2 Chinese) co-coded for interrater reliability.
Results
Preliminary analysis suggests that Australian participants emphasised positive body image through reclaiming aesthetics and autonomy, reflecting a view of the body as central to individual identity. In contrast, Chinese participants often linked positivity to maintaining bodily functionality and fulfilling family responsibilities—demonstrating resilience through continued productivity, frequently accompanied by a cultural silence around body image concerns. Therefore, while body image seemed more salient among Australian survivors, this difference likely reflects culturally distinct modes of expression rather than differing levels of concern. Australians verbalized both negative and positive body experiences, while Chinese participants enacted strength publicly and internalized distress privately.
Conclusions
The findings highlight culturally distinct experiences and expressions of positive body image, underscoring the need for psychosocial interventions that are sensitive to differing cultural values around the body, identity, and social roles in breast cancer recovery. This study also offer important insights into the experiences of survivors who remain silent about their bodily changes.