Skip to main content

Advertisement

SpringerLink
Log in

Factors associated with worsening sexual function during adjuvant endocrine therapy in a prospective clinic-based cohort of women with early-stage breast cancer

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

Abstract

Purpose

Sexual function problems are common but under-reported among women receiving adjuvant endocrine therapy for breast cancer. Worsening scores on patient-reported outcomes (PROs) may identify those at risk for sexual function problems during treatment. We performed a secondary analysis of prospectively collected PROs in women receiving adjuvant endocrine therapy to identify factors associated with worsening sexual function.

Methods

Women with stage 0–III breast cancer initiating adjuvant endocrine therapy participating in a prospective cohort completed PROs at baseline, 3, 6, 12, 24, 36, 48, and 60 months. Sexual function was evaluated by the MOS-SP measure. Other measures included PROMIS pain interference, fatigue, depression, anxiety, physical function, and sleep disturbance and the Endocrine Symptom Subscale of the FACT-ES. We evaluated associations between score worsening of at least the minimal important difference (MID) in PROMIS T-scores (4 points) and FACT-ES scores (5 points) with score worsening of at least the MID in MOS-SP scores (8 points) using logistic regression.

Results

Among 300 participants, 45.7% experienced ≥ 8-point worsening of MOS-SP score at any time point compared to baseline. Worsening endocrine symptoms (OR 1.34, 95% CI 1.22–1.49, p < 0.001), worsening physical function (OR 1.09, 95% CI 1.00–1.18, p = 0.06), and prior mastectomy (OR 1.45, 95% CI 0.94–2.23, p = 0.09) were associated with MOS-SP score worsening by at least the MID.

Conclusion

Worsening endocrine symptoms and physical function identified on PROs are associated with worsening sexual function during adjuvant endocrine therapy. Routine assessment of these domains with PROs may identify women at risk for sexual function problems.

Trial registration number

NCT01937052; Date of Registration: 09/09/2013.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Ribi K, Luo W, Walley BA, Burstein HJ, Chirgwin J, Ansari RH, Salim M, van der Westhuizen A, Abdi E, Francis PA, Chia S, Harvey VJ, Giobbie-Hurder A, Fleming GF, Pagani O, Di Leo A, Colleoni M, Gelber RD, Goldhirsch A, Coates AS, Regan MM, Bernhard J (2020) Treatment-induced symptoms, depression and age as predictors of sexual problems in premenopausal women with early breast cancer receiving adjuvant endocrine therapy. Breast Cancer Res Treat 181(2):347–359. https://doi.org/10.1007/s10549-020-05622-5

    Article  PubMed  Google Scholar 

  2. Kedde H, van de Wiel HBM, Weijmar Schultz WCM, Wijsen C (2013) Sexual dysfunction in young women with breast cancer. Support Care Cancer 21(1):271–280. https://doi.org/10.1007/s00520-012-1521-9

    Article  CAS  PubMed  Google Scholar 

  3. Baumgart J, Nilsson K, Evers AS, Kallak TK, Poromaa IS (2013) Sexual dysfunction in women on adjuvant endocrine therapy after breast cancer. Menopause 20(2):162–168. https://doi.org/10.1097/gme.0b013e31826560da

    Article  PubMed  Google Scholar 

  4. van Londen GJ, Beckjord EB, Dew MA, Cooper KL, Davidson NE, Bovbjerg DH, Donovan HS, Thurston RC, Morse JQ, Nutt S, Rechis R (2014) Associations between adjuvant endocrine therapy and onset of physical and emotional concerns among breast cancer survivors. Support Care Cancer 22(4):937–945. https://doi.org/10.1007/s00520-013-2041-y

    Article  PubMed  Google Scholar 

  5. Schover LR, Baum GP, Fuson LA, Brewster A, Melhem-Bertrandt A (2014) Sexual problems during the first 2 years of adjuvant treatment with aromatase inhibitors. J Sex Med 11(12):3102–3111. https://doi.org/10.1111/jsm.12684

    Article  PubMed  PubMed Central  Google Scholar 

  6. Robinson PJ, Bell RJ, Christakis MK, Ivezic SR, Davis SR (2017) Aromatase inhibitors are associated with low sexual desire causing distress and fecal incontinence in women: an observational study. J Sex Med 14(12):1566–1574. https://doi.org/10.1016/j.jsxm.2017.09.018

    Article  PubMed  Google Scholar 

  7. Oberguggenberger A, Martini C, Huber N, Fallowfield L, Hubalek M, Daniaux M, Sperner-Unterweger B, Holzner B, Sztankay M, Gamper E, Meraner V (2017) Self-reported sexual health: breast cancer survivors compared to women from the general population—an observational study. BMC Cancer 17(1):599–599. https://doi.org/10.1186/s12885-017-3580-2

    Article  PubMed  PubMed Central  Google Scholar 

  8. Raggio GA, Butryn ML, Arigo D, Mikorski R, Palmer SC (2014) Prevalence and correlates of sexual morbidity in long-term breast cancer survivors. Psychol Health 29(6):632–650. https://doi.org/10.1080/08870446.2013.879136

    Article  PubMed  PubMed Central  Google Scholar 

  9. Cella D, Fallowfield LJ (2008) Recognition and management of treatment-related side effects for breast cancer patients receiving adjuvant endocrine therapy. Breast Cancer Res Treat 107(2):167–180. https://doi.org/10.1007/s10549-007-9548-1

    Article  CAS  PubMed  Google Scholar 

  10. Bober SL, Varela VS (2012) Sexuality in adult cancer survivors: challenges and intervention. J Clin Oncol 30(30):3712–3719. https://doi.org/10.1200/JCO.2012.41.7915

    Article  PubMed  Google Scholar 

  11. Paiva CE, Rezende FF, Paiva BSR, Mauad EC, Zucca-Matthes G, Carneseca EC, Syrjänen KJ, Schover LR (2016) Associations of body mass index and physical activity with sexual dysfunction in breast cancer survivors. Arch Sex Behav 45(8):2057–2068. https://doi.org/10.1007/s10508-016-0758-7

    Article  PubMed  Google Scholar 

  12. Aerts L, Christiaens MR, Enzlin P, Neven P, Amant F (2014) Sexual functioning in women after mastectomy versus breast conserving therapy for early-stage breast cancer: a prospective controlled study. Breast 23(5):629–636. https://doi.org/10.1016/j.breast.2014.06.012

    Article  CAS  PubMed  Google Scholar 

  13. Fobair P, Stewart SL, Chang S, D’Onofrio C, Banks PJ, Bloom JR (2006) Body image and sexual problems in young women with breast cancer. Psychooncology 15(7):579–594. https://doi.org/10.1002/pon.991

    Article  PubMed  Google Scholar 

  14. Engel J, Kerr J, Schlesinger-Raab A, Sauer H, Hölzel D (2004) Quality of life following breast-conserving therapy or mastectomy: results of a 5-year prospective study. Breast J 10(3):223–231. https://doi.org/10.1111/j.1075-122X.2004.21323.x

    Article  PubMed  Google Scholar 

  15. Pérez M, Liu Y, Schootman M, Aft RL, Schechtman KB, Gillanders WE, Jeffe DB (2010) Changes in sexual problems over time in women with and without early-stage breast cancer. Menopause 17(5):924–937. https://doi.org/10.1097/gme.0b013e3181d5dd26

    Article  PubMed  PubMed Central  Google Scholar 

  16. Rosenberg SM, Tamimi RM, Gelber S, Ruddy KJ, Bober SL, Kereakoglow S, Borges VF, Come SE, Schapira L, Partridge AH (2014) Treatment-related amenorrhea and sexual functioning in young breast cancer survivors. Cancer 120(15):2264–2271. https://doi.org/10.1002/cncr.28738

    Article  PubMed  Google Scholar 

  17. Lee M, Kim YH, Jeon MJ (2015) Risk factors for negative impacts on sexual activity and function in younger breast cancer survivors. Psychooncology 24(9):1097–1103. https://doi.org/10.1002/pon.3772

    Article  CAS  PubMed  Google Scholar 

  18. Brédart A, Dolbeault S, Savignoni A, Besancenet C, This P, Giami A, Michaels S, Flahault C, Falcou MC, Asselain B, Copel L (2011) Prevalence and associated factors of sexual problems after early-stage breast cancer treatment: results of a French exploratory survey. Psychooncology 20(8):841–850. https://doi.org/10.1002/pon.1789

    Article  PubMed  Google Scholar 

  19. Rojas KE, Matthews N, Raker C, Clark MA, Onstad M, Stuckey A, Gass J (2018) Body mass index (BMI), postoperative appearance satisfaction, and sexual function in breast cancer survivorship. J Cancer Surviv 12(1):127–133. https://doi.org/10.1007/s11764-017-0651-y

    Article  CAS  PubMed  Google Scholar 

  20. Avis NE, Johnson A, Canzona MR, Levine BJ (2018) Sexual functioning among early post-treatment breast cancer survivors. Support Care Cancer 26(8):2605–2613. https://doi.org/10.1007/s00520-018-4098-0

    Article  PubMed  PubMed Central  Google Scholar 

  21. Burwell SR, Case LD, Kaelin C, Avis NE (2006) Sexual problems in younger women after breast cancer surgery. J Clin Oncol 24(18):2815–2821. https://doi.org/10.1200/JCO.2005.04.2499

    Article  PubMed  Google Scholar 

  22. Webber K, Mok K, Bennett B, Lloyd AR, Friedlander M, Juraskova I, Goldstein D, FolCan study (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(9):1333–1344. https://doi.org/10.1634/theoncologist.2011-0100

    Article  PubMed  PubMed Central  Google Scholar 

  23. Ganz PA, Desmond KA, Belin TR, Meyerowitz BE, Rowland JH (1999) Predictors of sexual health in women after a breast cancer diagnosis. J Clin Oncol 17(8):2371–2380. https://doi.org/10.1200/jco.1999.17.8.2371

    Article  CAS  PubMed  Google Scholar 

  24. Aptecar L, Fiteni F, Jarlier M, Delaine S, Guillerme V, Jacot W, D’Hondt V (2021) Prospective evaluation of sexual health in breast cancer women during the first year of adjuvant hormonal treatment using a cancer patient’s dedicated questionnaire: a glaring gap of communication between health professionals and patients. Breast Cancer Res Treat. https://doi.org/10.1007/s10549-020-06062-x

    Article  PubMed  Google Scholar 

  25. Carpenter JS, Johnson D, Wagner L, Andrykowski M (2002) Hot flashes and related outcomes in breast cancer survivors and matched comparison women. Oncol Nurs Forum 29(3):E16-25. https://doi.org/10.1188/02.onf.e16-e25

    Article  PubMed  Google Scholar 

  26. Oberguggenberger A, Hubalek M, Sztankay M, Meraner V, Beer B, Oberacher H, Giesinger J, Kemmler G, Egle D, Gamper EM, Sperner-Unterweger B, Holzner B (2011) Is the toxicity of adjuvant aromatase inhibitor therapy underestimated? Complementary information from patient-reported outcomes (PROs). Breast Cancer Res Treat 128(2):553–561. https://doi.org/10.1007/s10549-011-1378-5

    Article  CAS  PubMed  Google Scholar 

  27. Dai Y, Cook OY, Yeganeh L, Huang C, Ding J, Johnson CE (2020) Patient-reported barriers and facilitators to seeking and accessing support in gynecologic and breast cancer survivors with sexual problems: a systematic review of qualitative and quantitative studies. J Sex Med 17(7):1326–1358. https://doi.org/10.1016/j.jsxm.2020.03.004

    Article  PubMed  Google Scholar 

  28. Runowicz CD, Leach CR, Henry NL, Henry KS, Mackey HT, Cowens-Alvarado RL, Cannady RS, Pratt-Chapman ML, Edge SB, Jacobs LA, Hurria A, Marks LB, LaMonte SJ, Warner E, Lyman GH, Ganz PA (2016) American cancer society/american society of clinical oncology breast cancer survivorship care guideline. J Clin Oncol 34(6):611–635. https://doi.org/10.1200/jco.2015.64.3809

    Article  CAS  PubMed  Google Scholar 

  29. NCCN (2020) Survivorship (Version 2.2020). https://www.nccn.org/professionals/physician_gls/pdf/survivorship.pdf.

  30. Mazzarello S, Hutton B, Ibrahim MFK, Jacobs C, Shorr R, Smith S, Ng T, Clemons M (2015) Management of urogenital atrophy in breast cancer patients: a systematic review of available evidence from randomized trials. Breast Cancer Res Treat 152(1):1–8. https://doi.org/10.1007/s10549-015-3434-z

    Article  CAS  PubMed  Google Scholar 

  31. Hummel SB, van Lankveld J, Oldenburg HSA, Hahn DEE, Kieffer JM, Gerritsma MA, Kuenen MA, Bijker N, Borgstein PJ, Heuff G, Lopes Cardozo AMF, Plaisier PW, Rijna H, van der Meij S, van Dulken EJ, Vrouenraets BC, Broomans E, Aaronson NK (2017) Efficacy of internet-based cognitive behavioral therapy in improving sexual functioning of breast cancer survivors: results of a randomized controlled trial. J Clin Oncol 35(12):1328–1340. https://doi.org/10.1200/jco.2016.69.6021

    Article  PubMed  Google Scholar 

  32. Goetsch MF, Lim JY, Caughey AB (2015) A practical solution for dyspareunia in breast cancer survivors: a randomized controlled trial. J Clin Oncol 33(30):3394–3400. https://doi.org/10.1200/jco.2014.60.7366

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Yang EJ, Lim JY, Rah UW, Kim YB (2012) Effect of a pelvic floor muscle training program on gynecologic cancer survivors with pelvic floor dysfunction: a randomized controlled trial. Gynecol Oncol 125(3):705–711. https://doi.org/10.1016/j.ygyno.2012.03.045

    Article  PubMed  Google Scholar 

  34. Barton DL, Sloan JA, Shuster LT, Gill P, Griffin P, Flynn K, Terstriep SA, Rana FN, Dockter T, Atherton PJ, Tsai M, Sturtz K, Lafky JM, Riepl M, Thielen J, Loprinzi CL (2018) Evaluating the efficacy of vaginal dehydroepiandosterone for vaginal symptoms in postmenopausal cancer survivors: NCCTG N10C1 (Alliance). Support Care Cancer 26(2):643–650. https://doi.org/10.1007/s00520-017-3878-2

    Article  PubMed  Google Scholar 

  35. Bailey P, Chang DK, Nones K, Johns AL, Patch AM, Gingras MC, Miller DK, Christ AN, Bruxner TJ, Quinn MC, Nourse C, Murtaugh LC, Harliwong I, Idrisoglu S, Manning S, Nourbakhsh E, Wani S, Fink L, Holmes O, Chin V, Anderson MJ, Kazakoff S, Leonard C, Newell F, Waddell N, Wood S, Xu Q, Wilson PJ, Cloonan N, Kassahn KS, Taylor D, Quek K, Robertson A, Pantano L, Mincarelli L, Sanchez LN, Evers L, Wu J, Pinese M, Cowley MJ, Jones MD, Colvin EK, Nagrial AM, Humphrey ES, Chantrill LA, Mawson A, Humphris J, Chou A, Pajic M, Scarlett CJ, Pinho AV, Giry-Laterriere M, Rooman I, Samra JS, Kench JG, Lovell JA, Merrett ND, Toon CW, Epari K, Nguyen NQ, Barbour A, Zeps N, Moran-Jones K, Jamieson NB, Graham JS, Duthie F, Oien K, Hair J, Grutzmann R, Maitra A, Iacobuzio-Donahue CA, Wolfgang CL, Morgan RA, Lawlor RT, Corbo V, Bassi C, Rusev B, Capelli P, Salvia R, Tortora G, Mukhopadhyay D, Petersen GM, Australian Pancreatic Cancer Genome I, Munzy DM, Fisher WE, Karim SA, Eshleman JR, Hruban RH, Pilarsky C, Morton JP, Sansom OJ, Scarpa A, Musgrove EA, Bailey UM, Hofmann O, Sutherland RL, Wheeler DA, Gill AJ, Gibbs RA, Pearson JV, Waddell N, Biankin AV, Grimmond SM (2016) Genomic analyses identify molecular subtypes of pancreatic cancer. Nature 531(7592):47–52. https://doi.org/10.1038/nature16965

    Article  CAS  PubMed  Google Scholar 

  36. Snyder CF, Blackford AL, Wolff AC, Carducci MA, Herman JM, Wu AW, Patient Viewpoint Scientific Advisory B (2013) Feasibility and value of patient viewpoint: a web system for patient-reported outcomes assessment in clinical practice. Psychooncology 22(4):895–901. https://doi.org/10.1002/pon.3087

    Article  PubMed  Google Scholar 

  37. Snyder CF, Jensen R, Courtin SO, Wu AW, Website for Outpatient QOLARN (2009) PatientViewpoint: a website for patient-reported outcomes assessment. Qual Life Res 18(7):793–800. https://doi.org/10.1007/s11136-009-9497-8

    Article  PubMed  PubMed Central  Google Scholar 

  38. Sherbourne CD (1992) Social functioning: sexual problems measures. In: Stewart AL, Ware JE (eds) Measuring functioning and well-being the medical outcomes study approach. Duke University Press, Durham, N.C, London

    Google Scholar 

  39. Sloan JA, Dueck A (2004) Issues for statisticians in conducting analyses and translating results for quality of life end points in clinical trials. J Biopharm Stat 14(1):73–96. https://doi.org/10.1081/BIP-120028507

    Article  CAS  PubMed  Google Scholar 

  40. Revicki D, Hays RD, Cella D, Sloan J (2008) Recommended methods for determining responsiveness and minimally important differences for patient-reported outcomes. J Clin Epidemiol 61(2):102–109. https://doi.org/10.1016/j.jclinepi.2007.03.012

    Article  PubMed  Google Scholar 

  41. Jensen RE, Moinpour CM, Potosky AL, Lobo T, Hahn EA, Hays RD, Cella D, Smith AW, Wu XC, Keegan TH, Paddock LE, Stroup AM, Eton DT (2017) Responsiveness of 8 patient-reported outcomes measurement information system (PROMIS) measures in a large, community-based cancer study cohort. Cancer 123(2):327–335. https://doi.org/10.1002/cncr.30354

    Article  PubMed  Google Scholar 

  42. Jensen RE, Potosky AL, Moinpour CM, Lobo T, Cella D, Hahn EA, Thissen D, Smith AW, Ahn J, Luta G, Reeve BB (2017) United States population-based estimates of patient-reported outcomes measurement information system symptom and functional status reference values for individuals with cancer. J Clin Oncol 35(17):1913–1920. https://doi.org/10.1200/JCO.2016.71.4410

    Article  PubMed  PubMed Central  Google Scholar 

  43. Schalet BD, Pilkonis PA, Yu L, Dodds N, Johnston KL, Yount S, Riley W, Cella D (2016) Clinical validity of PROMIS depression, anxiety, and anger across diverse clinical samples. J Clin Epidemiol 73:119–127. https://doi.org/10.1016/j.jclinepi.2015.08.036

    Article  PubMed  PubMed Central  Google Scholar 

  44. Teresi JA, Ocepek-Welikson K, Kleinman M, Ramirez M, Kim G (2016) Measurement equivalence of the patient reported outcomes measurement information system. Psychol Test Assess Model 58(1):183–219

    PubMed  PubMed Central  Google Scholar 

  45. Fallowfield LJ, Leaity SK, Howell A, Benson S, Cella D (1999) Assessment of quality of life in women undergoing hormonal therapy for breast cancer: validation of an endocrine symptom subscale for the FACT-B. Breast Cancer Res Treat 55(2):189–199. https://doi.org/10.1023/a:1006263818115

    Article  CAS  PubMed  Google Scholar 

  46. Yost KJ, Eton DT, Garcia SF, Cella D (2011) Minimally important differences were estimated for six patient-reported outcomes measurement information system-cancer scales in advanced-stage cancer patients. J Clin Epidemiol 64(5):507–516. https://doi.org/10.1016/j.jclinepi.2010.11.018

    Article  PubMed  PubMed Central  Google Scholar 

  47. Zager S, Mendu ML, Chang D, Bazick HS, Braun AB, Gibbons FK, Christopher KB (2011) Neighborhood poverty rate and mortality in patients receiving critical care in the academic medical center setting. Chest 139(6):1368–1379. https://doi.org/10.1378/chest.10-2594

    Article  PubMed  PubMed Central  Google Scholar 

  48. Liang K-Y, Zeger SL (1986) Longitudinal data analysis using generalized linear models. Biometrika 73(1):13–22. https://doi.org/10.1093/biomet/73.1.13

    Article  Google Scholar 

  49. Pan W (2001) Akaike’s information criterion in generalized estimating equations. Biometrics 57(1):120–125. https://doi.org/10.1111/j.0006-341x.2001.00120.x

    Article  CAS  PubMed  Google Scholar 

  50. R Core Team (2020) R: A language and environment for statistical computing. R Foundation for Statistical Computing. Vienna, Austria

  51. Henry NL, Azzouz F, Desta Z, Li L, Nguyen AT, Lemler S, Hayden J, Tarpinian K, Yakim E, Flockhart DA, Stearns V, Hayes DF, Storniolo AM (2012) Predictors of aromatase inhibitor discontinuation as a result of treatment-emergent symptoms in early-stage breast cancer. J Clin Oncol 30(9):936–942. https://doi.org/10.1200/JCO.2011.38.0261

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. Smith SG, Sestak I, Howell A, Forbes J, Cuzick J (2017) Participant-reported symptoms and their effect on long-term adherence in the international breast cancer intervention study I (IBIS I). J Clin Oncol 35(23):2666–2673. https://doi.org/10.1200/JCO.2016.71.7439

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Sestak I, Smith SG, Howell A, Forbes JF, Cuzick J (2018) Early participant-reported symptoms as predictors of adherence to anastrozole in the international breast cancer intervention studies II. Ann Oncol 29(2):504–509. https://doi.org/10.1093/annonc/mdx713

    Article  CAS  PubMed  Google Scholar 

  54. Chang HY, Jotwani AC, Lai YH, Jensen MP, Syrjala KL, Fann JR, Gralow J (2016) Hot flashes in breast cancer survivors: frequency, severity and impact. Breast 27:116–121. https://doi.org/10.1016/j.breast.2016.02.013

    Article  PubMed  Google Scholar 

  55. Lowery-Allison AE, Passik SD, Cribbet MR, Reinsel RA, O’Sullivan B, Norton L, Kirsh KL, Kavey NB (2018) Sleep problems in breast cancer survivors 1–10 years posttreatment. Palliat Support Care 16(3):325–334. https://doi.org/10.1017/S1478951517000311

    Article  PubMed  Google Scholar 

  56. Smedsland SK, Vandraas KF, Bøhn SK, Dahl AA, Kiserud CE, Brekke M, Falk RS, Reinertsen KV (2022) Sexual activity and functioning in long-term breast cancer survivors; exploring associated factors in a nationwide survey. Breast Cancer Res Treat 193(1):139–149. https://doi.org/10.1007/s10549-022-06544-0

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  57. Cella D, Riley W, Stone A, Rothrock N, Reeve B, Yount S, Amtmann D, Bode R, Buysse D, Choi S, Cook K, Devellis R, DeWalt D, Fries JF, Gershon R, Hahn EA, Lai JS, Pilkonis P, Revicki D, Rose M, Weinfurt K, Hays R (2010) The patient-reported outcomes measurement information system (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005–2008. J Clin Epidemiol 63(11):1179–1194. https://doi.org/10.1016/j.jclinepi.2010.04.011

    Article  PubMed  PubMed Central  Google Scholar 

  58. Jensen RE, Potosky AL, Reeve BB, Hahn E, Cella D, Fries J, Smith AW, Keegan TH, Wu XC, Paddock L, Moinpour CM (2015) Validation of the PROMIS physical function measures in a diverse US population-based cohort of cancer patients. Qual Life Res 24(10):2333–2344. https://doi.org/10.1007/s11136-015-0992-9

    Article  PubMed  PubMed Central  Google Scholar 

  59. Sitlinger A, Shelby RA, Van Denburg AN, White H, Edmond SN, Marcom PK, Bosworth HB, Keefe FJ, Kimmick GG (2019) Higher symptom burden is associated with lower function in women taking adjuvant endocrine therapy for breast cancer. J Geriatr Oncol 10(2):317–321. https://doi.org/10.1016/j.jgo.2018.11.008

    Article  PubMed  Google Scholar 

  60. Rodriguez JA, Hobart SJ, Deshmukh AJ, Menken LG, Ranawat AS, Rathod PA (2021) Improved sexual function after total hip and knee arthroplasty for osteoarthritis. Orthopedics 44(2):111–116. https://doi.org/10.3928/01477447-20210104-01

    Article  PubMed  Google Scholar 

  61. Blair CK, Robien K, Inoue-Choi M, Rahn W, Lazovich D (2016) Physical inactivity and risk of poor quality of life among elderly cancer survivors compared to women without cancer: the Iowa women’s health study. J Cancer Surviv 10(1):103–112. https://doi.org/10.1007/s11764-015-0456-9

    Article  PubMed  Google Scholar 

  62. Markopoulos C, Tsaroucha AK, Kouskos E, Mantas D, Antonopoulou Z, Karvelis S (2009) Impact of breast cancer surgery on the self-esteem and sexual life of female patients. J Int Med Res 37(1):182–188. https://doi.org/10.1177/147323000903700122

    Article  CAS  PubMed  Google Scholar 

  63. Link-Gelles R, Westreich D, Aiello AE, Shang N, Weber DJ, Holtzman C, Scherzinger K, Reingold A, Schaffner W, Harrison LH, Rosen JB, Petit S, Farley M, Thomas A, Eason J, Wigen C, Barnes M, Thomas O, Zansky S, Beall B, Whitney CG, Moore MR (2016) Bias with respect to socioeconomic status: a closer look at zip code matching in a pneumococcal vaccine effectiveness study. SSM—Popul Health 2:587–594. https://doi.org/10.1016/j.ssmph.2016.08.005

    Article  PubMed  PubMed Central  Google Scholar 

  64. Dyer K, das Nair R (2013) Why don’t healthcare professionals talk about sex? A systematic review of recent qualitative studies conducted in the United Kingdom. J Sex Med 10(11):2658–2670. https://doi.org/10.1111/j.1743-6109.2012.02856.x

    Article  PubMed  Google Scholar 

  65. Snyder CF, Jensen RE, Segal JB, Wu AW (2013) Patient-reported outcomes (PROs): putting the patient perspective in patient-centered outcomes research. Med Care 51(8 Suppl 3):S73-79. https://doi.org/10.1097/MLR.0b013e31829b1d84

    Article  PubMed  PubMed Central  Google Scholar 

  66. Barbera L, Sutradhar R, Earle CC, Howell D, Mittman N, Li Q, Thiruchelvam D, Seow H (2020) The impact of routine Edmonton symptom assessment system use on receiving palliative care services: results of a population-based retrospective-matched cohort analysis. BMJ Support Palliat Care. https://doi.org/10.1136/bmjspcare-2020-002220

    Article  PubMed  Google Scholar 

  67. Graupner C, Kimman ML, Mul S, Slok AHM, Claessens D, Kleijnen J, Dirksen CD, Breukink SO (2021) Patient outcomes, patient experiences and process indicators associated with the routine use of patient-reported outcome measures (PROMs) in cancer care: a systematic review. Support Care Cancer 29(2):573–593. https://doi.org/10.1007/s00520-020-05695-4

    Article  PubMed  Google Scholar 

  68. Cui J, Qian G (2007) Selection of working correlation structure and best model in GEE analyses of longitudinal data. Commun Stat Simul Comput. https://doi.org/10.1080/03610910701539617

    Article  Google Scholar 

  69. Ribi K, Luo W, Bernhard J, Francis PA, Burstein HJ, Ciruelos E, Bellet M, Pavesi L, Lluch A, Visini M, Parmar V, Tondini C, Kerbrat P, Perello A, Neven P, Torres R, Lombardi D, Puglisi F, Karlsson P, Ruhstaller T, Colleoni M, Coates AS, Goldhirsch A, Price KN, Gelber RD, Regan MM, Fleming GF (2016) Adjuvant tamoxifen plus ovarian function suppression versus tamoxifen alone in premenopausal women with early breast cancer: patient-reported outcomes in the suppression of ovarian function trial. J Clin Oncol 34(14):1601–1610. https://doi.org/10.1200/JCO.2015.64.8675

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Funding

This work was supported by funding from the Susan G. Komen Foundation and the National Institutes of Health [P30 CA006973].

Author information

Authors and Affiliations

  1. Johns Hopkins Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Neha Verma & Claire Snyder

  2. Division of Biostatistics and Bioinformatics, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA

    Amanda L. Blackford

  3. Johns Hopkins Women’s Malignancies Program, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Elissa Thorner, Jennifer Lehman, Vered Stearns & Karen Lisa Smith

  4. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Claire Snyder

  5. Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Claire Snyder

  6. Medical Oncology, Johns Hopkins Sidney Kimmel Cancer Center at Sibley Memorial Hospital, First Floor, Building B, 5255 Loughboro Road, NW, Washington, DC, 20016, USA

    Karen Lisa Smith

Authors
  1. Neha Verma
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Amanda L. Blackford
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Elissa Thorner
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jennifer Lehman
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Claire Snyder
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Vered Stearns
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Karen Lisa Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Conceptualization: KLS, NV, and VS. Data Curation: JL. Formal Analysis: ALB. Funding Acquisition: VS. Methodology: KLS, ALB, VS, and CS. Resources: VS, JL, and CS. Software: not applicable. Supervision: KLS and VS. Writing of the original draft: NV and KLS. Writing, reviewing, and editing of the manuscript: All authors.

Corresponding author

Correspondence to Karen Lisa Smith.

Ethics declarations

Conflict of interest

Karen Lisa Smith has received research support (to institution) from Pfizer. Karen Lisa Smith’s spouse has stock ownership in ABT Labs and Abbvie. Vered Stearns has received research grants (to institution) from Abbvie, Biocept, Pfizer, Puma Biotechnology, and Novartis. Vered Stearns has been on an advisory board for Novartis (10/25/21). Vered Stearns is a Data Safety Monitoring Board member for Immunomedics, Inc. and for AstraZeneca. Vered Stearns has received non-financial support from Foundation Medicine for Study Assays. Claire Snyder has research funding (to institution) from Pfizer and Genentech and has received personal consulting fees from Janssen via Health Outcomes Solutions. Elissa Thorner has received research support (to institution) from Pfizer. The following authors declare that they have no conflicts of interest related to the work presented in this manuscript: Neha Verma, Amanda Blackford, and Jennifer Lehman.

Research involving human participants and/or animals

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. We obtained approval from the Johns Hopkins (JH) Institutional Review Board (IRB) to conduct this prospective study. All participants signed written informed consent.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 35 kb)

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Verma, N., Blackford, A.L., Thorner, E. et al. Factors associated with worsening sexual function during adjuvant endocrine therapy in a prospective clinic-based cohort of women with early-stage breast cancer. Breast Cancer Res Treat 196, 535–547 (2022). https://doi.org/10.1007/s10549-022-06750-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-022-06750-w

Keywords

Search

Navigation