Breast cancer survivor's sexual health unmet supportive care needs: a mixed-methods study

Breast cancer is one of the most common malignancies affecting women worldwide. Despite advances in early detection and treatment improving long-term survival rates, the sexual health needs of breast cancer survivors (BCS) remain overlooked due to the predominant focus on biomedical outcomes. In Portugal, as in many other countries, these needs are frequently neglected, despite evidence showing their significant impact on the quality of life. This study aims to explore the unmet sexual health needs of BCS in Portugal, identify barriers to addressing these issues in oncological settings, and outline key requirements for developing effective interventions to improve their quality of life.

A mixed-methods design was used, combining quantitative data from 336 BCS, assessed using the Female Sexual Function Index (FSFI) and EORTC QLQ-C30/BR23 questionnaires, with qualitative data from semi-structured interviews with 11 survivors. Interviews explored unmet sexual health needs and satisfaction with oncology support services. Data were analyzed descriptively and thematically.

Quantitative findings showed low sexual functioning, particularly in desire and arousal, and high levels of sexual pain. Emotional functioning scored lowest in quality-of-life assessments, with fatigue, insomnia, and pain as prevalent symptoms. Qualitative results highlighted unmet needs, including a lack of sexuality-related information, body image concerns, limited psychosexual support, and insufficient partner involvement.

Participants reported poor sexual functioning and quality of life, with critical sexual health needs unaddressed in care.

Integrating tailored sexual health support-including psychoeducational and therapeutic interventions-into oncology services may enhance survivors' emotional well-being, relational intimacy, and overall quality of life.