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Trends in Sexual Function After Breast Cancer Surgery

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

Sexual dysfunction is assumed to be common, but understudied, in breast cancer patients. Herein, we use the validated female sexual functioning index (FSFI) to evaluate changes in female sexual function after breast cancer surgery.

Methods

The FSFI assesses sexual function in six domains (desire, arousal, lubrication, orgasm, satisfaction, pain) on a 36-point scale, with scores >26.6 indicating better sexual function. We identified 226 women with unilateral breast cancer undergoing surgery at our institution from June 2010–January 2015. All completed the FSFI preoperatively and at a median of 13 months postoperatively. We quantified declines in FSFI scores and considered p-values <0.05 statistically significant.

Results

Overall, 119 women had breast-conserving surgery (BCS), 40 had unilateral mastectomy (UM), and 67 had UM plus contralateral prophylactic mastectomy (CPM). All women had similar baseline FSFI scores (medians: BCS, 26.3; UM, 25.2; UM+CPM, 23.7; p = 0.23). At follow-up, sexual function had declined significantly in BCS (23.5; p < 0.001) and UM (17.4; p = 0.010), but was unchanged in UM+CPM (22.8; p = 0.74) women. Interestingly, all women maintained their desire for sex (p = 0.17). BCS and UM women demonstrated significant declines in all other subscale domains (all p < 0.045). UM+CPM women demonstrated no decline in any subscale domain, yet did not exhibit superior sexual function to those having UM or BCS (medians: BCS, 23.5; UM, 17.4; UM+CPM, 22.8; p = 0.21).

Conclusions

Baseline sexual dysfunction exists in women diagnosed with breast cancer. Surgery negatively impacts sexual function. Patients who choose mastectomy do not exhibit superior sexual function over those having BCS at 13 months following surgery.

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Funding

No sources of funding were used to assist in the preparation of this study.

Disclosure

Lauren F. Cornell, Dawn M. Mussallem, Tammeza C. Gibson, Nancy N. Diehl, Sanjay P. Bagaria, and Sarah A. McLaughlin have no conflicts of interest to declare.

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Authors and Affiliations

  1. Division of Hematology and Medical Oncology, Mayo Clinic, Jacksonville, FL, USA

    Lauren F. Cornell MD, Dawn M. Mussallem MD, Tammeza C. Gibson PA-C, Sanjay P. Bagaria MD & Sarah A. McLaughlin MD

  2. Division of General Surgery, Mayo Clinic, Jacksonville, FL, USA

    Tammeza C. Gibson PA-C, Sanjay P. Bagaria MD & Sarah A. McLaughlin MD

  3. Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL, USA

    Nancy N. Diehl BS

Authors
  1. Lauren F. Cornell MD
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  2. Dawn M. Mussallem MD
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  3. Tammeza C. Gibson PA-C
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  4. Nancy N. Diehl BS
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  5. Sanjay P. Bagaria MD
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  6. Sarah A. McLaughlin MD
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Corresponding author

Correspondence to Sarah A. McLaughlin MD.

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Cornell, L.F., Mussallem, D.M., Gibson, T.C. et al. Trends in Sexual Function After Breast Cancer Surgery. Ann Surg Oncol 24, 2526–2538 (2017). https://doi.org/10.1245/s10434-017-5894-3

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  • DOI: https://doi.org/10.1245/s10434-017-5894-3

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