Sexual Dysfunction in Breast Cancer Survivors: Is it Surgical Modality or Adjuvant Therapy?

Sexual dysfunction is common in breast cancer survivors. Our survey study aimed to delineate the relative associations between sexual dysfunction and breast cancer treatment including surgical modalities and adjuvant therapies. Women in surveillance following breast cancer surgery were eligible for our survey incorporating the Female Sexual Function Index. Analysis involved multiple log-binomial regression to evaluate the association between sexual dysfunction (Female Sexual Function Index≤26.55) and treatment modality. Of the 600 completed surveys, the final eligible analytic sample included 278 sexually active respondents. Overall, 65%, 27%, and 8% underwent lumpectomy, mastectomy with reconstruction, and mastectomy alone, respectively. In total, 74.5% reported receipt of radiation; 47.8% chemotherapy; 27.3% tamoxifen, and 31.4% aromatase inhibitor (AI). No significant difference in prevalence of sexual dysfunction was observed by surgical modality, even when adjusted for adjuvant therapy. Chemotherapy or radiation was not associated with sexual dysfunction when adjusted for surgical modality. The prevalence of sexual dysfunction was 1.6 times higher for the AI group compared with the no endocrine therapy group (P=0.01), when adjusted for other treatment groups. Our study demonstrated that the highest rates of sexual dysfunction were among breast cancer survivors treated with AI. Neither surgical modality, chemotherapy, nor radiation was associated with sexual dysfunction. These data may guide clinicians in counseling sexually active breast cancer patients in treatment planning and survivorship.