Sexual Health in Postmastectomy Breast Reconstruction Patients and Value of an Intervention: A Qualitative Study

In this qualitative study, we assessed patients' perception of how postmastectomy breast reconstruction (PMBR) impacts sexual health and the perceived value of consultations with the sexual medicine team.

PMBR patients were recruited for four focus groups, two with patients who had sexual medicine consultations and two with patients who did not. Patients completed two surveys, BREAST-Q Sexual Well-being and Patient-Reported Outcomes Measurement Information System (PROMIS) Sexual function and satisfaction (SexFS). Focus groups were audio-taped, transcribed, and analyzed thematically.

There were 35 participants, 17 patients who received sexual medicine consultations and 18 patients who did not. The median Sexual Well-being score was 48 (Interquartile range: 31, 53) and PROMIS SexFS scores were lower than the United States adults' scores. Analysis identified six major themes: (1) patient experience of physical and nonphysical impacts of diagnosis and treatment that lead to a decline in sexual health, (2) utilization of clinical and nonclinical strategies to address sexual health concerns, (3) patient perception of importance of sexual health and how it is often overlooked in oncology care broadly and in plastic surgery specifically, (4) desired information about sexual health, (5) patient desire for a dedicated place to discuss their sexual health concerns, and (6) desired aspects of sexual medicine consultations.

Patients perceive a decline in their sexual health as a result of breast cancer diagnosis and treatment, with specific challenges associated with PMBR. Patients desire a dedicated space to discuss sexual health concern, and sexual medicine consultations are one possible approach.