Female sexual function in breast cancer referred at the tertiary level
Main Article Content
Keywords
Mastectomy, Radical, Breast Neoplasms, Drug Therapy, Radiation, Sexual Dysfunction
Abstract
Background: Little is known about sexual function in patients with a previous breast cancer diagnosis. Treatments for breast cancer can cause structural and functional damage at different levels, affecting quality of life and emotional well-being of patients. This can produce pain, inhibition of sexual desire and difficulties in intimacy as a result of mastectomy, tumoral resection, radiation, chemotherapy and hormonal therapy.
Objective: To evaluate sexual function in females with breast cancer remission.
Material and methods: An observational, cross-sectional study was conducted in patients with breast cancer remission, attending consultation in the Oncology and Physical Medicine and Rehabilitation departments during the period from August to October 2024, who underwent the Female Sexual Function Index (FSFI) questionnaire.
Results: 129 patients were included. A high rate of sexual dysfunction was found 104 (80.6%) despite having a stable partner or being married. An adequate level of sexual function was observed in 14 (18.6%) of patients treated with radical mastectomy without reconstruction, while the highest scores were found in patients who underwent mastectomy and reconstruction.
Conclusions: Most patients treated with mastectomy without reconstruction presented with sexual dysfunction. Patients treated with mastectomy and reconstruction exhibited adequate sexual function.
References
1. World Health Organization. Cáncer de mama. Published March 13, 2024. Disponible en: https://www.who.int/es/news-room/fact-sheets/detail/breast-cancer.
2. MilkZoft. Consenso de cáncer mamario - México. Published 2023. Disponible en: http://consensocancermamario.com/actualizacion.html.
3. Vasallo-López C, Figueredo-Garlobo L, Blanco-Paredes G, López, et al. Evaluación del nivel de los conocimientos sobre el cáncer de mama en mujeres en edad fértil. EsTuSalud. 2021;3(3):e124. Disponible en: https://revestusalud.sld.cu/index.php/estusalud/article/view/124/112.
4. National Cancer Institute. (2024). BRCA Gene Changes: Cancer Risk and Genetic Testing Fact Sheet.
5. Osorio BN, Bello HC, Vega BL. Factores de riesgo asociados al cáncer de mama. Rev Cubana Med Gen Integr. 2020;36(2):1-13.
6. Obeagu EI, Obeagu GU. Breast cancer: A review of risk factors and diagnosis. Medicine (Baltimore). 2024;103(3):e36905. doi: 10.1097/MD.0000000000036905.
7. Nanda A, Hu J, Hodgkinson S, et al. Oncoplastic breast-conserving surgery for women with primary breast cancer. Cochrane Library. 2021(10). doi: 10.1002/14651858.cd013658.pub2.
8. Hickey BE, Lehman M. Partial breast irradiation versus whole breast radiotherapy for early breast cancer. Cochrane Database Syst Rev. 2021;8(8):CD007077. doi: 10.1002/14651858.CD007077.pub4.
9. Ben-Dror J, Shalamov M, Sonnenblick A. The history of early breast cancer treatment. Genes (Basel). 2022;13(6):960. Published May 27, 2022. doi: 10.3390/genes13060960.
10. Tesch ME, Partridge AH. Treatment of breast cancer in young adults. Am Soc Clin Oncol Educ Book. 2022;42:1–12. doi: 10.1200/EDBK_360970.
11. Kerr AJ, Dodwell D, McGale P, et al. Cancer Treatment Reviews. 2022;105:102375.
12. Trayes KP, Cokenakes SEH. Breast cancer treatment. Am Fam Physician. 2021;104(2):171-178.
13. Jehan M, Azam S, Taimuri MA, et al. Care for breast cancer survivors in Asian countries: A review of sexual dysfunction. Womens Health (Lond). 2024;20:17455057241237687. doi: 10.1177/17455057241237687.
14. Luo F, Link M, Grabenhorst C, et al. Low sexual desire in breast cancer survivors and patients: A review. Sex Med Rev. 2022;10(3):367-375. doi: 10.1016/j.sxmr.2022.02.001.
15. Blümel JE, Binfa L, Cataldo P, et al. Índice de función sexual femenina: un test para evaluar la sexualidad de la mujer. Rev Chil Obstet Ginecol. 2004;69(2):118-125. Disponible en: http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0717-75262004000200006. doi:10.4067/S0717-75262004000200006.
16. World Health Organization. Sexual health. Accessed December 5, 2024. Disponible en: https://www.who.int/es/health-topics/sexual-health#tab=tab_1.
17. Bober SL, Falk SJ. Female sexual health and cancer. Clin Obstet Gynecol. 2025;68(1):51–59. doi:10.1097/GRF.0000000000000918.
18. Hernández-Blanquisett A, Quintero-Carreño V, Álvarez-Londoño A, et al. Sexual dysfunction as a challenge in treated breast cancer: In-depth analysis and risk assessment to improve individual outcomes. Front Oncol. 2022;12:955057. doi: 10.3389/fonc.2022.955057.
19. Smith T, Kingsberg SA, Faubion S. Sexual dysfunction in female cancer survivors: Addressing the problems and the remedies. Maturitas. 2022;165:52–57. doi: 10.1016/j.maturitas.2022.07.010.
20. Marsh S, Borges VF, Coons HL, et al. Sexual health after a breast cancer diagnosis in young women: Clinical implications for patients and providers. Breast Cancer Res Treat. 2020;184(3):655-663. doi: 10.1007/s10549-020-05880-3.
21. Penberthy JK, Stewart AL, Centeno CF, et al. Psychological aspects of breast cancer. Psychiatr Clin North Am. 2023;46(3):551–570. doi: 10.1016/j.psc.2023.04.010.
22. Vale F, Rezende C, Raciclan A, Bretas T, Geber S. Efficacy and safety of a non-hormonal intravaginal moisturizer for the treatment of vaginal dryness in postmenopausal women with sexual dysfunction. Eur J Obstet Gynecol Reprod Biol. 2019;234:92-95. doi: 10.1016/j.ejogrb.2018.12.040
23. Sánchez-Prieto M, Pingarrón C, Bergamaschi L, et al. Prospective, multicenter, uncontrolled study on the effectiveness and safety of a hyaluronic acid water-based vaginal lubricant in alleviating vaginal dryness and dyspareunia. Gynecol Endocrinol. 2024;40(1):2317268. doi: 10.1080/09513590.2024.2317268
24. Vegunta S, Kuhle CL, Vencill JA, et al. Sexual health after a breast cancer diagnosis: Addressing a forgotten aspect of survivorship. J Clin Med. 2022;11(22):6723. Published November 14, 2022. doi: 10.3390/jcm11226723.
25. Dinapoli L, Colloca G, Di Capua B, et al. Psychological aspects to consider in breast cancer diagnosis and treatment. Curr Oncol Rep. 2021;23(3):38. doi: 10.1007/s11912-021-01049-3.
26. Jorge CH, Bø K, Chiazuto Catai C, et al. Pelvic floor muscle training as treatment for female sexual dysfunction: a systematic review and meta-analysis. Am J Obstet Gynecol. 2024;231(1):51–66.e1. doi: 10.1016/j.ajog.2024.01.001.
27. Cucciniello L, Miglietta F, Guarneri V, et al. Managing sexual health challenges in breast cancer survivors: A comprehensive review. Breast. 2024;76:103754. doi: 10.1016/j.breast.2024.103754.
28. Puklin LS, Harrigan M, Cartmel B, Sanft T, et al. Randomized trial evaluating a self-guided lifestyle intervention on changes in body weight, diet, physical activity, and quality of life among breast cancer survivors. Cancers. 2023;15(19):4719. doi: 10.3390/cancers15194719.
Article Sidebar
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors retain their copyright and grant the Revista Médica del IMSS the right of first publication. Articles are distributed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which allows sharing as long as the author and the original source are properly credited.