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Trends in Sexual Function After Breast Cancer Surgery
Lauren F Cornell1, Dawn M Mussallem1, Tammeza C Gibson1,2
1Division of Hematology and Medical Oncology, Mayo Clinic, Jacksonville, FL, USA.
Annals of Surgical Oncology
|June 1, 2017
Summary
Breast cancer surgery negatively impacts sexual function, with declines noted after breast-conserving surgery and unilateral mastectomy. However, sexual function remained stable after prophylactic mastectomy, though not superior to other surgical approaches.
Area of Science:
- Oncology
- Gynecology
- Sexual Medicine
Background:
- Sexual dysfunction is a prevalent yet understudied concern among breast cancer patients.
- Understanding the impact of different surgical interventions on female sexual health is crucial for comprehensive patient care.
Purpose of the Study:
- To evaluate changes in female sexual function following breast cancer surgery using the Female Sexual Functioning Index (FSFI).
- To compare sexual function outcomes across different surgical approaches: breast-conserving surgery (BCS), unilateral mastectomy (UM), and UM with contralateral prophylactic mastectomy (CPM).
Main Methods:
- The validated Female Sexual Functioning Index (FSFI), assessing six domains of sexual function, was administered to 226 women preoperatively and at a median of 13 months postoperatively.
- Participants were categorized based on surgical procedure: BCS (n=119), UM (n=40), and UM+CPM (n=67).
- Statistical analysis quantified FSFI score declines, with p-values <0.05 considered significant.
Main Results:
- While baseline sexual function was similar across groups, significant declines were observed postoperatively in BCS (median 23.5, p < 0.001) and UM (median 17.4, p = 0.010) patients.
- Sexual function remained unchanged in UM+CPM patients (median 22.8, p = 0.74), although their scores were not superior to those in the BCS or UM groups.
- Desire for sex was maintained across all groups (p = 0.17), but BCS and UM patients showed significant declines in other sexual function domains (p < 0.045).
Conclusions:
- Breast cancer surgery, particularly BCS and UM, leads to a significant negative impact on female sexual function.
- While prophylactic mastectomy did not result in a decline in sexual function, it did not confer superior sexual health outcomes compared to other surgical methods at 13 months post-surgery.
- The findings highlight the need for proactive screening and management of sexual dysfunction in breast cancer survivors.
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