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Sexual health in long-term breast cancer survivors

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

Sexual dysfunction is reported in women with breast cancer (BC). It is unclear whether symptoms persist over time as data comparing long-term survivors to controls are lacking. We compared sexual functioning in long-term breast cancer survivors (BCS) to controls and determined the impact of adjuvant therapy on sexual health.

Methods

A cohort of women with localized BC (1989–1996) was prospectively followed. BCS and controls (2005–2007) completed self-reported questionnaires. Sexual health was measured with the Sexual Activity Questionnaire (SAQ). Vasomotor, gynecological, and bladder symptoms were scored using the Menopausal Symptom Scale. Regression analysis was used to compare groups, with adjustment for age and secondly menopausal status.

Results

BCS (n = 248, 87%) and controls (n = 159, 95%) completed the SAQ at a median time from diagnosis of 12.5 years. BCS were older (62 vs 59 years, p = 0.0004) and more likely to be menopausal (94 vs 86%, p = 0.0025). Sexual activity did not differ significantly between BCS and controls, but when adjusted for menopausal status, pre/peri-menopausal BCS were less likely to be sexually active than pre/peri-controls (odds ratio OR 0.12, p = 0.012). In those sexually active, no significant differences were noted on the SAQ Pleasure, Discomfort, and Habit scales. BCS reported worse gynecological symptoms and pre/peri-menopausal patients had more bladder complaints (standardized effect size 0.36 p = 0.002 and 1.11, p = 0.011). Adjuvant treatments were not significantly associated with sexual function, but BCS treated with chemotherapy reported worse gynecological symptoms.

Conclusion

Sexual health and uro-genital symptom counseling should be provided to BCS, particularly pre/peri-menopausal patients, even at long-term follow-up.

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References

  1. Howlader N, Noone AM, Krapcho M et al (2016) SEER Cancer Statistics Review, 1975–2013, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2013/, based on November 2015 SEER data submission, posted to the SEER web site

  2. Early Breast Cancer Trialists’ Collaborative Group (2005) Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet 365:1687–1717

    Article  Google Scholar 

  3. Carter J, Stabile C, Seidel B et al (2015) Baseline characteristics and concerns of female cancer patients/survivors seeking treatment at a Female Sexual Medicine Program. Support Care Cancer 23:2255–2265

    Article  Google Scholar 

  4. Scanlon M, Blaes A, Geller M et al (2012) Patient satisfaction with physician discussions of treatment impact on fertility, menopause and sexual health among pre-menopausal women with cancer. J Cancer 3:217–225

    Article  Google Scholar 

  5. Speer J, Hillenberg B, Sugrue D et al (2005) Study of sexual functioning determinants in breast cancer survivors. Breast J 11:440–447

    Article  Google Scholar 

  6. Burwell SR, Case DL, Kaelin C, Avis NE (2006) Sexual problems in younger women after breast cancer surgery. J Clin Oncol 24:2815–2821

    Article  Google Scholar 

  7. Ganz PA, Rowland JH, Desmond K et al (1998) Life after breast cancer: understanding women’s health-related quality of life and sexual functioning. J Clin Oncol 16:501–514

    Article  CAS  Google Scholar 

  8. Lee M, Kim YH, Jeon MJ (2015) Risk factors for negative impacts on sexual activity and function in younger breast cancer survivors. Psychooncology 24:1097–1103

    Article  CAS  Google Scholar 

  9. Schover LR, Baum GP, Fuson LA et al (2014) Sexual problems during the first 2 years of adjuvant treatment with aromatase inhibitors. J Sex Med 11:3102–3111

    Article  Google Scholar 

  10. Rosenberg SM, Tamimi RM, Gelber S et al (2014) Treatment-related amenorrhea and sexual functioning in young breast cancer survivors. Cancer 120:2264–2271

    Article  Google Scholar 

  11. Webber K, Mok K, Bennett B et al (2011) If I am in the mood, I enjoy it: an exploration of cancer-related fatigue and sexual functioning in women with breast cancer. Oncologist 16:1333–1344

    Article  Google Scholar 

  12. Yang EJ, Kim SW, Heo CY, Lim JY (2011) Longitudinal changes in sexual problems related to cancer treatment in Korean breast cancer survivors: a prospective cohort study. Support Care Cancer 19:909–918

    Article  Google Scholar 

  13. Conde DM, Pinto-Neto AM, Cabello C et al (2005) Menopause symptoms and quality of life in women aged 45–65 years with and without breast cancer. Menopause 12:436–443

    Article  Google Scholar 

  14. Ganz PA, Desmond KA, Leedham B et al (2002) Quality of life in long-term, disease-free survivors of breast cancer: a follow-up study. J Natl Cancer Inst 94:39–49

    Article  Google Scholar 

  15. Raggio GA, Butryn ML, Arigo D et al (2014) Prevalence and correlates of sexual morbidity in long-term breast cancer survivors. Psychol Health 29:632–650

    Article  Google Scholar 

  16. Davis SR, Panjari M, Robinson PJ et al (2014) Menopausal symptoms in breast cancer survivors nearly 6 years after diagnosis. Menopause 21:1–7

    Article  Google Scholar 

  17. Lindau ST, Schumm LP, Laumann EO et al (2007) A study of sexuality and health among older adults in the United States. N Engl J Med 357:762–774

    Article  CAS  Google Scholar 

  18. Baumgart J, Nilsson K, Evers AS et al (2013) Sexual dysfunction in women on adjuvant endocrine therapy after breast cancer. Menopause 20:162–168

    PubMed  Google Scholar 

  19. Cavalheiro JA, Bittelbrunn A, Menke CH et al (2012) Sexual function and chemotherapy in postmenopausal women with breast cancer. BMC Womens Health 11:12–28

    Google Scholar 

  20. Bloom JR (2004) Then and now: quality of life of young breast cancer survivors. Psychooncology 13:147–160

    Article  Google Scholar 

  21. Joly F, Espie M, Marty M et al (2000) Long-term quality of life in premenopausal women with node-negative localized breast cancer treated with or without adjuvant chemotherapy. Br J Cancer 83:577–582

    Article  CAS  Google Scholar 

  22. Hopwood P, Haviland J, Mills J et al (2007) The impact of age and clinical factors on quality of life in early breast cancer: an analysis of 2208 women recruited to the UK START Trial (Standardisation of Breast Radiotherapy Trial). Breast 16:241–251

    Article  Google Scholar 

  23. Arora NK, Gustafson DH, Hawkins RP et al (2001) Impact of surgery and chemotherapy on the quality of life of younger women with breast carcinoma: a prospective study. Cancer 92:1288–1298

    Article  CAS  Google Scholar 

  24. Mortimer JE, Boucher L, Baty J et al (1999) Effect of tamoxifen on sexual functioning in patients with breast cancer. J Clin Oncol 17:1488–1492

    Article  CAS  Google Scholar 

  25. Ganz P, Desmond K, Belin T et al (1999) Predictors of sexual health in women after a breast cancer diagnosis. J Clin Oncol 17:2371–2380

    Article  CAS  Google Scholar 

  26. Ganz P, Kwan L, Stanton A et al (2004) Quality of life at the end of primary treatment of breast cancer: first results from the moving beyond cancer randomized trial. J Natl Cancer Inst 96:376–387

    Article  Google Scholar 

  27. Frechette D, Paquet L, Verma S et al (2013) The impact of endocrine therapy on sexual dysfunction in postmenopausal women with early stage breast cancer: encouraging results from a prospective study. Breast Cancer Res Treat 141:111–117

    Article  CAS  Google Scholar 

  28. Berglund G, Nystedt M, Bolund C et al (2001) Effect of endocrine treatment on sexuality in premenopausal breast cancer patients: a prospective randomized study. J Clin Oncol 19:2788–2796

    Article  CAS  Google Scholar 

  29. Tina Hsu M, Ennis N, Hood et al (2013) Quality of life in long-term breast cancer survivors. J Clin Oncol 31:3540–3548

    Article  Google Scholar 

  30. Thirlaway K, Fallowfield L, Cuzick J (1996) The Sexual Activity Questionnaire: a measure of women’s sexual functioning. Qual Life Res 5:81–90

    Article  CAS  Google Scholar 

  31. Ganz PA, Day R, Ware JE Jr et al (1995) Base-line quality-of-life assessment in the National Surgical Adjuvant Breast and Bowel Project Breast Cancer Prevention Trial. J Natl Cancer Inst 87:1372–1382

    Article  Google Scholar 

  32. Ganz PA, Greendale GA, Petersen L et al (2000) Managing menopausal symptoms in breast cancer survivors: results of a randomized controlled trial. J Natl Cancer Inst 92:1054–1064

    Article  CAS  Google Scholar 

  33. Bartula I, Sherman KA (2013) Screening for sexual dysfunction in women diagnosed with breast cancer: systematic review and recommendations. Breast Cancer Res Treat 141:173–185

    Article  Google Scholar 

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Funding

This work was supported by The Breast Cancer Research Foundation and Hold ‘EM For Life Translating Research Discoveries Into Breast Cancer Cures. The study sponsors have no role in the design of the study, the collection, analysis, and interpretation of the data, the manuscript writing, or the decision to submit for publication.

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Authors and Affiliations

  1. Department of Hematology and Oncology, CISSS Montérégie Centre/Hôpital Charles-Lemoyne, Centre Affilié de l’Université de Sherbrooke, Greenfield Park, Canada

    Sara V. Soldera

  2. Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University Health Network, University of Toronto, Toronto, Canada

    Sara V. Soldera

  3. Applied Statistician, Markham, Canada

    Marguerite Ennis

  4. Division of Medical Oncology and Hematology, Division of Clinical Epidemiology, Department of Medicine, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Canada

    Ana E. Lohmann & Pamela J. Goodwin

Authors
  1. Sara V. Soldera
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  2. Marguerite Ennis
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  4. Pamela J. Goodwin
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Corresponding author

Correspondence to Sara V. Soldera.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The research ethics committee at the Mount Sinai Hospital approved this study. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Written informed consent was obtained from all individual participants included in the study.

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Soldera, S.V., Ennis, M., Lohmann, A.E. et al. Sexual health in long-term breast cancer survivors. Breast Cancer Res Treat 172, 159–166 (2018). https://doi.org/10.1007/s10549-018-4894-8

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  • DOI: https://doi.org/10.1007/s10549-018-4894-8

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