Quality of life and sexual functioning in young women with early-stage breast cancer 1 year after lumpectomy.

The breast cancer (BC) and its treatment (mastectomy, radiotherapy, and chemotherapy) have considerable psychosexual impacts on women's life. This study evaluated sexual functioning, quality of life, and self-esteem in young women with early-stage BC. A total of 186 women with stage I or II BC and 204 age-matched controls aged 25-45 years were recruited. To be eligible, patients had to be disease-free and sexually active. They also had to have undergone lumpectomy at least 1 year previously and have completed chemotherapy and/or radiotherapy. Subjects completed Female Sexual Function Index, Short Form-36 Health Survey, and Rosenberg Self-Esteem questionnaire. Serum sex hormones were also measured in all subjects. Of BC patients, 57% experienced lubrication disorder followed by satisfaction disorder in 53.8%, desire disorder in 42.5%, and arousal disorder in 37.0% (all patients vs. healthy controls <0.01). Hormone-treated patients were more likely to report sexual dysfunctions (p = 0.006). The radiotherapy + chemotherapy + hormone therapy was associated with an about sixfold increased risk of lubrication and satisfaction disorders (adjusted odds ratios = 6.4, 95%CI = 4.6-12.6, and adjusted odds ratios = 5.7, 95%CI = 3.4-11.4, respectively). Cancer patients had lower scores for all components of the Short Form-36 Health Survey, except for pain. Levels of self-esteem did not differ significantly between the two groups. Young lumpectomized BC women reported a marked impairment in sexual functioning and quality of life.

Safarinejad MR ，Shafiei N ，Safarinejad S 《-》

Sexual functioning in women after mastectomy versus breast conserving therapy for early-stage breast cancer: a prospective controlled study.

Breast cancer (BC) and/or its treatments may affect sexual functioning based on physiological and psychosocial mechanisms. The aim of this study was to prospectively investigate sexual adjustment of BC patients during a follow-up period of one year after mastectomy (ME) or breast conserving therapy (BCT). In this prospective controlled study, women with BC and an age-matched control group of healthy women completed the Beck Depression Inventory Scale, World Health Organization 5 Well-being scale, Body Image Scale, EORTC QLQ questionnaire, Dyadic Adjustment Scale, Short Sexual Functioning Scale and Specific Sexual Problems Questionnaire to assess various aspects of sexual and psychosocial functioning before surgery, six months and one year after surgical treatment. In total, 149 women with BC and 149 age-matched healthy controls completed the survey. Compared to the situation before surgery, significantly more BCT women reported problems with sexual arousal six months after surgery and significantly more women of the ME group reported problems with sexual desire, arousal and the ability to achieve an orgasm six months and one year after surgery. While in comparison with healthy controls, no significant differences in sexual functioning were found after BCT surgery, significantly more women who underwent ME reported problems with sexual desire, arousal, the ability to achieve an orgasm and intensity of the orgasm. Although little differences were seen in sexual functioning in the BCT group during prospective analyses and in comparison with healthy controls, analyses revealed that women who underwent a ME were at risk for post-operative sexual dysfunctions.

Aerts L ，Christiaens MR ，Enzlin P ，Neven P ，Amant F ... -  《-》

Prevalence and associated factors of sexual problems after early-stage breast cancer treatment: results of a French exploratory survey.

The objective of this study was to assess the prevalence and associated factors of sexual activity, sexual problems or sexual satisfaction in French early-stage breast cancer survivors (BCS). Eight hundred and fifty eligible, post-treatment (6 months-5 years) female patients, aged 18-70 years, randomly selected from a consultation list, were invited to fill in questionnaires exploring quality of life (EORTC QLQ-C30 and QLQ-BR23), body image scale, and sexuality (Sexual Activity Questionnaire-SAQ; Relationship and Sexuality Scale; French Sexual Behaviour Survey-CSF). Fifty-three percent of BCS agreed to participate. Participating women (n=378) were younger, more often premenopausal at diagnosis and with a more recent diagnosis than non-respondents. The prevalence of sexual problems was significantly higher in BCS compared with adjusted data from a French female representative sample (p<0.0001). In logistic regression, no sexual activity (R(2) =0.37) or sexual dissatisfaction (R(2) =0.28) were associated with the feeling of emotional separation in the couple or of partner's fear of sexual intercourse, lower emotional functioning, poorer body image, or co-morbidities. In sexually active women (71% of respondents), lower frequency of sexual activity (R(2) =0.26), lower sexual pleasure (R(2) =0.22), or higher sexual discomfort (R(2) =0.22) were associated with the feeling of emotional separation in the couple or of partner's fear of sexual intercourse, lower emotional functioning, age (>50 years), nausea, or insomnia (all Hosmer-Lemeshow tests: p=NS). Psychological factors including the perception of the couple relationship appeared prominent in BCS women's experience of sexual problems.

Brédart A ，Dolbeault S ，Savignoni A ，Besancenet C ，This P ，Giami A ，Michaels S ，Flahault C ，Falcou MC ，Asselain B ，Copel L ... -  《-》

Factors Associated With Specific Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Sexual Dysfunctions in Breast Cancer Survivors: A Study of Patients and Their Partners.

Many women develop sexual problems after breast cancer (BC) treatment. Little is known about BC survivors with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) sexual dysfunction and their partners, and the factors associated with their sexual functioning. To evaluate (i) patient-related and clinical factors associated with (a) specific DSM-IV sexual dysfunctions and (b) level of sexual functioning and sexual distress as reported by BC survivors and (ii) the association between the sexual functioning of BC survivors and that of their partners. We analyzed baseline data from a study of the efficacy of online cognitive-behavioral therapy for sexual dysfunction in BC survivors. Women completed self-report questionnaires assessing sexual functioning, sexual distress, relationship intimacy, marital functioning, menopausal symptoms, body image, and psychological distress. Their partners completed questionnaires assessing sexual functioning. The study included 169 BC survivors and 67 partners. The most prevalent female sexual dysfunctions were hypoactive sexual desire disorder (HSDD; 83%), sexual arousal disorder (40%), and dyspareunia (33%). Endocrine therapy was associated with HSDD (P = .003), and immunotherapy was associated with dyspareunia (P = .009). Older age was associated with lower sexual distress (P < .001). Depressive symptoms were highest in women with sexual arousal disorder (P = .004). An indication for erectile disorder was present in two thirds of partners. Lower overall partner sexual satisfaction was associated with lower overall BC survivor sexual functioning (P = .001), lower female arousal (P = .002), and lower female sexual satisfaction (P = .001). Poorer male erectile function was related to higher female sexual pain (P = .006). Partners of women who underwent breast reconstruction reported marginally significantly better orgasmic functioning (P = .012) and overall sexual functioning (P = .015) than partners of women who had undergone breast-conserving treatment. BC survivors and their partners experience sexual problems after BC treatment. This suggests that not only the BC survivor but also her partner could benefit from sexual counseling. This is the first study focusing on BC survivors with a DSM-IV sexual dysfunction and their partners. The results cannot necessarily be generalized to women experiencing milder sexual problems or who have no interest in receiving sexual counseling. Endocrine therapy and immunotherapy are relevant risk factors for HSDD and dyspareunia in BC survivors. The sexual functioning of women and their partners is affected, underscoring the importance of involving both partners in sexual counseling after BC treatment. Hummel SB, Hahn DEE, van Lankveld JJDM, et al. Factors Associated With Specific Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Sexual Dysfunctions in Breast Cancer Survivors: A Study of Patients and Their Partners. J Sex Med 2017;14:1248-1259.

Hummel SB ，Hahn DEE ，van Lankveld JJDM ，Oldenburg HSA ，Broomans E ，Aaronson NK ... -  《-》

Investigating Sexual Function and Affecting Factors in Women with Breast Cancer in Iran.

Shandiz FH ，Karimi FZ ，Rahimi N ，Abdolahi M ，Anbaran ZK ，Ghasemi M ，Mazlom SR ，Kheirabadi AN ... -  《-》