Objectives Patients with breast cancer often receive invasive treatments, with impact on appearance which can affect body image. We aimed to evaluate the impact of breast cancer and its treatments on the body image of Tunisian patients.

Methods Between February and April 2021, thirty-nine patients with breast cancer answered the 10-item body image scale (BIS) questionnaire. Patients responded to questions about relationships with the partner and entourage and to express opinion about breast reconstruction and appearance care.

Results The median age was 47 years. Fifty-four percent underwent Patey’s modified radical mastectomy and 46% lumpectomy with axillary node dissection. All patients received chemotherapy, 54% radiotherapy, 61% endocrine therapy and 46% Trastuzumab. Lymphedema was reported in 20% of cases. Twenty-three percent were dissatisfied with the scar’s appearance. A change for the worse in partner behavior was reported with 8% of patients. Forty-one percent described society’s pitying looks. Only 8% wanted to undergo a breast reconstruction surgery. Taking care of body appearance was reported to be ‘little’ by 38%, ‘quite a bit’ by 54% and ‘very much’ by 8%. Twenty-three percent expressed low Self confidence. The median BIS score was 9.69 [1–26]. Score under 10 was reported in 54% of cases, between 10 and 20 in 38% and over 20 in 8%. The median BIS score was higher in the radical surgery group (p=0.048).

Conclusions Body Image perception seemed to be affected by the disease and its treatments especially the radical surgery. A psychological care is needed to reduce this impact.