Sexual Health in Pre-menopausal Breast Cancer Survivors

Sexual health is often a neglected issue and affects the quality of life after treatment completion in breast cancer patients. The aim of the study was to find the incidence of sexual dysfunction and impact of mastectomy, breast conservation surgery (BCS), and hormone therapy in eligible patients on female sexuality in breast cancer survivors. It is a prospective study of 150 non-metastatic pre-menopausal BC survivors. Each participant answered the Female Sexual Function Index (FSFI) questionnaire at 4 weeks and at 3 months after completion of all therapy. Scores were compared between mastectomy and BCS patients and on hormonal therapy versus non-hormonal therapy. Chemotherapy was given to all patients and > 90% received adjuvant radiotherapy. Patients underwent both mastectomy (n = 104; 70%) and BCS (n = 46), based on imaging, staging, and patients' choice. Of the patients, 82.6% (n = 124) had sexual dysfunction at 3 months post-treatment (cutoff of 26.55). BCS survivors had significantly better scores in comparison to mastectomy survivors at 3-month interval evaluation (median 22.85 ± 2.19 versus 21.75 ± 2.09, p = 0.002). There was statistically non-significant reduction in arousal, lubrication, orgasm, pain in mastectomy survivors, and in desire, arousal, and pain in hormonal group survivors, at 3 months follow-up. Overall sexual dysfunction is high in breast cancer survivors irrespective of therapy (82.6%); however, it is more in patients undergoing mastectomy in comparison to patients undergoing conservative surgery in short-term follow-up. Sexual dysfunction issues needs to be addressed during survivorship programs, and longer follow-up is necessary to assess effect of various treatment modalities.