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Sexual concerns of women diagnosed with breast cancer-related lymphedema

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Abstract

Purpose

Lymphedema is a common side effect of breast cancer treatment that may negatively impact on a woman’s physical and psychological well-being. This study aimed to understand the impact of breast cancer-related lymphedema on women’s sexual functioning, and to identify key concerns of these women regarding sexual issues.

Methods

Purposive sampling recruited 17 women aged 38–67 years with mild to severe lymphedema. Telephone interviews concerning sexual issues were transcribed verbatim and thematic analysis undertaken.

Results

Women perceived sexual concerns arising from lymphedema to exacerbate concerns arising from breast cancer. Four interrelated factors determined the extent of lymphedema’s sexual impact: (a) swelling severity and location, (b) needing to wear a compression garment, (c) body image concerns raised by lymphedema and breast cancer treatment, and (d) their sexual partner’s acceptance and supportiveness. In particular, a supportive partner was instrumental in assisting women to overcome sexual issues caused by severe swelling and/or body image concerns. Few women reported being asked about sexual issues by any health professional, and most women indicated that they were unwilling to discuss sexual concerns with health professionals, friends, or family.

Conclusions

Lymphedema had the potential to accentuate sexual issues caused by breast cancer, but most women were reluctant to discuss issues with anyone other than their partner. These findings are relevant to health professionals designing breast cancer psychosexual interventions and future research addressing lymphedema-specific sexual concerns.

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References

  1. DiSipio T, Rye S, Newman B, Hayes S (2013) Incidence of unilateral arm lymphoedema after breast cancer: a systematic review and meta-analysis. Lancet Oncol 14(6):500–515. doi:10.1016/s1470-2045(13)70076-7

    Article  PubMed  Google Scholar 

  2. Ridner SH (2013) Pathophysiology of lymphedema. Semin Oncol Nurs 29(1):4–11. doi:10.1016/j.soncn.2012.11.002

    Article  PubMed  Google Scholar 

  3. Ridner SH, Bonner CM, Deng J, Sinclair VG (2012) Voices from the shadows: living with lymphedema. Cancer Nurs 35(1):E18–E26. doi:10.1097/NCC.0b013e31821404c0

    Article  PubMed Central  PubMed  Google Scholar 

  4. Greenslade MV, House CJ (2006) Living with lymphedema: a qualitative study of women's perspectives on prevention and management following breast cancer-related treatment. Can Oncol Nurs J 16(3):165–179

    Article  PubMed  Google Scholar 

  5. Pusic A, Cemal Y, Albornoz C, Klassen A, Cano S, Sulimanoff I, Hernandez M, Massey M, Cordeiro P, Morrow M, Mehrara B (2013) Quality of life among breast cancer patients with lymphedema: a systematic review of patient-reported outcome instruments and outcomes. J Cancer Survivorship 7(1):83–92. doi:10.1007/s11764-012-0247-5

    Article  Google Scholar 

  6. Morgan PA, Franks PJ, Moffatt CJ (2005) Health-related quality of life with lymphoedema: a review of the literature. Int Wound J 2(1):47–62. doi:10.1111/j.1742-4801.2005.00066.x

    Article  PubMed  Google Scholar 

  7. Gilbert E, Ussher JM, Perz J (2010) Sexuality after breast cancer: a review. Maturitas 66(4):397–407. doi:10.1016/j.maturitas.2010.03.027

    Article  PubMed  Google Scholar 

  8. Kinamore C (2008) Assessing and supporting body image and sexual concerns for young women with breast cancer: a literature review. J Radiother Pract 7(03):159–171

    Article  Google Scholar 

  9. Schover L (1993) Sexuality and body image in younger women with breast cancer. J Natl Cancer Inst Monogr 16:177–182

    Google Scholar 

  10. Moyer A (1997) Psychosocial outcomes of breast-conserving surgery versus mastectomy: a meta-analytic review. Health Psychol 16(3):284

    Article  CAS  PubMed  Google Scholar 

  11. Ussher JM, Perz J, Gilbert E (2011) Sexual wellbeing and breast cancer in Australia: experiences of people with breast cancer and health professionals. School of Psychology University of Western Sydney, Sydney, Australia and Breast Cancer Network Australia (BCNA), Melbourne

    Google Scholar 

  12. Kissane D, White K, Cooper K, Vitetta L (2004) Psychosocial impact in the areas of body image and sexuality for women with breast cancer. The National Breast Cancer Centre, Sydney

    Google Scholar 

  13. Bartula I, Sherman KA (2013) Screening for sexual dysfunction in women diagnosed with breast cancer: systematic review and recommendations. Breast Cancer Res Treat 141(2):173–185. doi:10.1007/s10549-013-2685-9

    Article  PubMed Central  PubMed  Google Scholar 

  14. Ussher JM, Perz J, Gilbert E (2012) Changes to sexual well-being and intimacy after breast cancer. Cancer Nurs 35(6):456–465. doi:10.1097/NCC.0b013e3182395401

    Article  PubMed  Google Scholar 

  15. Przezdziecki A, Sherman KA, Baillie A, Taylor A, Foley E, Stalgis-Bilinski K (2013) My changed body: breast cancer, body image, distress and self-compassion. Psycho-Oncology 22(8):1872–1879. doi:10.1002/pon.3230

    Article  PubMed  Google Scholar 

  16. Wetzig N, Gill PG, Zannino D, Stockler MR, Gebski V, Ung O, Campbell I, Simes RJ (2014) Sentinel lymph node based management or routine axillary clearance? Three-year outcomes of the RACS sentinel node biopsy versus axillary clearance (SNAC) 1 trial. Ann Surg Oncol 1–7

  17. Radina E, Watson W, Faubert K (2008) Lymphoedema and sexual relationships in mid/later life. J Lymphoedema 3(2):21–30

    Google Scholar 

  18. 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(7):909–918. doi:10.1007/s00520-010-0885-y

    Article  PubMed  Google Scholar 

  19. Panjari M, Bell RJ, Davis SR (2011) Sexual function after breast cancer. J Sex Med 8(1):294–302. doi:10.1111/j.1743-6109.2010.02034.x

    Article  PubMed  Google Scholar 

  20. Fu MR, Ridner SH, Hu SH, Stewart BR, Cormier JN, Armer JM (2013) Psychosocial impact of lymphedema: a systematic review of literature from 2004 to 2011. Psychooncology 22(7):1466–1484. doi:10.1002/pon.3201

    Article  PubMed Central  PubMed  Google Scholar 

  21. International Society of Lymphology (2013) The diagnosis and treatment of peripheral lymphedema: 2013 Consensus Document of the International Society of Lymphology. Lymphology 46(1):1–11

    Google Scholar 

  22. Braun V, Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3(2):77–101. doi:10.1191/1478088706qp063oa

    Article  Google Scholar 

  23. Glaser BG, Strauss AL (2009) The discovery of grounded theory: strategies for qualitative research. Transaction Books, Piscataway

    Google Scholar 

  24. Alder J, Zanetti R, Wight E, Urech C, Fink N, Bitzer J (2008) Sexual dysfunction after premenopausal stage I and II breast cancer: do androgens play a role? J Sex Med 5(8):1898–1906. doi:10.1111/j.1743-6109.2008.00893.x

    Article  PubMed  Google Scholar 

  25. Boehmer U, Timm A, Ozonoff A, Potter J (2012) Explanatory factors of sexual function in sexual minority women breast cancer survivors. Ann Oncol 23(11):2873–2878. doi:10.1093/annonc/mds099

    Article  CAS  PubMed  Google Scholar 

  26. Schover LR, Rhodes MM, Baum G, Adams JH, Jenkins R, Lewis P, Jackson KE (2011) Sisters Peer Counseling in Reproductive Issues After Treatment (SPIRIT): a peer counseling program to improve reproductive health among African American breast cancer survivors. Cancer 117(21):4983–4992. doi:10.1002/cncr.26139

    Article  PubMed Central  PubMed  Google Scholar 

  27. Gilbert E, Ussher JM, Perz J (2010) Renegotiating sexuality and intimacy in the context of cancer: the experiences of carers. Arch Sex Behav 39(4):998–1009. doi:10.1007/s10508-008-9416-z

    Article  PubMed  Google Scholar 

  28. Garrusi B, Faezee H (2008) How do Iranian women with breast cancer conceptualize sex and body image? Sex Disabil 26(3):159–165

    Article  Google Scholar 

  29. Zee B, Huang C, Mak S, Wong J, Chan E, Yeo W (2008) Factors related to sexual health in Chinese women with breast cancer in Hong Kong. Asia‐Pac J Clin Oncol 4(4):218–226

    Google Scholar 

  30. Hawkins Y, Ussher J, Gilbert E, Perz J, Sandoval M, Sundquist K (2009) Changes in sexuality and intimacy after the diagnosis and treatment of cancer: the experience of partners in a sexual relationship with a person with cancer. Cancer Nurs 32(4):271–280

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors would like to acknowledge contributions by the following people: Ms. Margaret McCaskill, for conducting interviews; Ms. Leigh Murray, for assistance in coding and interpretation; and Ms. Asha Heydon-White, for assistance in recruitment.

Conflict of interest

The authors have no conflicts of interest to disclose. The authors have full control of the primary data and can allow the journal to review the data if requested.

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Authors and Affiliations

  1. Macquarie University Cancer Institute, Australian School of Advanced Medicine, Macquarie University, Sydney, New South Wales, 2109, Australia

    Caleb J. Winch, Louise A. Koelmeyer, Katriona M. Smith, Helen Mackie & John Boyages

  2. Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, 2109, Australia

    Kerry A. Sherman

  3. Mount Wilga Private Hospital, 66 Rosamond Street, Hornsby, New South Wales, 2077, Australia

    Helen Mackie

Authors
  1. Caleb J. Winch
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  2. Kerry A. Sherman
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  3. Louise A. Koelmeyer
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  4. Katriona M. Smith
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  5. Helen Mackie
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  6. John Boyages
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Corresponding author

Correspondence to Kerry A. Sherman.

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Winch, C.J., Sherman, K.A., Koelmeyer, L.A. et al. Sexual concerns of women diagnosed with breast cancer-related lymphedema. Support Care Cancer 23, 3481–3491 (2015). https://doi.org/10.1007/s00520-015-2709-6

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  • DOI: https://doi.org/10.1007/s00520-015-2709-6

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