Journal of Cancer Survivorship

, Volume 12, Issue 1, pp 127–133 | Cite as

Body mass index (BMI), postoperative appearance satisfaction, and sexual function in breast cancer survivorship

  • K. E. RojasEmail author
  • N. Matthews
  • C. Raker
  • M. A. Clark
  • M. Onstad
  • A. Stuckey
  • J. Gass



We sought to explore the correlation between BMI and postoperative sexual function, body image, and breast-specific sensuality before and after breast cancer surgery.


A cross-sectional survey of patients at least 1 year from surgery employed the Female Sexual Function Index (FSFI) and investigator-generated questions. Patients who underwent lumpectomy (L), mastectomy (M), and mastectomy with reconstruction (MR) were compared across three BMI groups: normal weight, overweight, and obese.


Two hundred fifty-five patients underwent lumpectomy (L, n = 174), mastectomy (M, n = 22), or mastectomy with reconstruction (MR, n = 59). Median age was 57 (range 30–93) and median BMI was 28 (range 19–45). Obese and overweight women reported more appearance dissatisfaction (18.1 and 13.0%) than normal weight women (4.1%) (p = 0.01). Lower satisfaction was associated with increasing BMI within the MR group (p = 0.05). The obese group’s median FSFI score met criteria for sexual dysfunction (25.90, range 11.30–33.10). More overweight women reported their chest played an important role in intimacy before and after surgery, but a postoperative decline in the importance of this role was observed in all groups.


Greater post-treatment BMI is inversely related to postoperative appearance satisfaction, particularly in those undergoing mastectomy with reconstruction. The role of the breast in intimacy is greatest in overweight women, but decreases postoperatively in all BMI groups.

Implications for cancer survivors

Postoperative appearance satisfaction and sexual function seems to be correlated to post-treatment BMI, which highlights the need to encourage perioperative weight management for improved survivorship outcomes.


Breast cancer Intimacy Mastectomy Nipple sparing Sexuality Survivorship Body mass index Obesity 



We would like to thank all of the patients who participated in our study, as well as Sara Fogarty, D.O., Sarah Pesek, M.D., and Rebecca Kwait, M.D. for their contribution to the study. We would also like to thank the dedicated employees of Women and Infants’ Breast Health Center.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflicts of interest.

Ethical approval

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

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


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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • K. E. Rojas
    • 1
    Email author
  • N. Matthews
    • 2
  • C. Raker
    • 3
  • M. A. Clark
    • 4
  • M. Onstad
    • 5
  • A. Stuckey
    • 6
  • J. Gass
    • 7
  1. 1.Department of Obstetrics and Gynecology, Women and Infants’ HospitalAlpert Medical School of Brown UniversityProvidenceUSA
  2. 2.Alpert Medical School of Brown UniversityProvidenceUSA
  3. 3.Division of Research, Women and Infants’ HospitalProvidenceUSA
  4. 4.Center for Health Policy and Research, Department of Quantitative Health SciencesUniversity of Massachusetts Medical SchoolWorcesterUSA
  5. 5.Department of Gynecologic OncologyUniversity of Texas MD Anderson Cancer CenterHoustonUSA
  6. 6.The Program in Women’s OncologyWomen and Infants’ Hospital, Alpert Medical School of Brown UniversityProvidenceUSA
  7. 7.Department of Surgery, Women and Infants’ HospitalAlpert Medical School of Brown UniversityProvidenceUSA

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