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Pathology or New Norm? Reframing Social Constraints in Breast Cancer Survivors: A Scoping Review
1Department of Nursing, Korea National University of Transportation, Jeungpyeong-gun, Republic of Korea; and Department of Nursing, The University of Suwon, Hwaseong-si, Republic of Korea.
Abstract:
While medical advancements have significantly increased breast cancer survival rates, current survivorship often remains trapped within a biomedical framework that views physical alterations merely as deficits to be fixed. Consequently, the lived experience of survivors involves persistent body surveillance and cultural stigma that conflict with societal norms. Guided by Georges Canguilhem's philosophy of normativity, this scoping review maps social constraints in breast cancer survivors using the Arksey and O'Malley framework and Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews guidelines. Analysis of 13 eligible studies reveals that stigma-manifesting as self-stigma and cancer-stigma-serves as a primary antecedent to social constraints, with cultural background significantly influencing its intensity. These constraints often force survivors into silence and isolation, reinforcing the perception of altered bodies as pathological. From a holistic nursing perspective, however, physical changes should not be viewed as failures of recovery but as the genesis of new biological constants. This review argues for a paradigm shift from mere coping to renorming-empowering survivors to establish a valid new normal. This approach honors the survivor's agency in reclaiming ownership of their health, aligning with the core tenet of holistic practice: the integration of the altered self into a meaningful, integrated whole.