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Sexual dysfunction and reproductive concerns in young women with breast cancer: Type, prevalence, and predictors of problems

Lisa Ljungman, Johan Ahlgren, Lena‐Marie Petersson and 5 more

Psycho-Oncology · 2018 · CC BY

doi:10.1002/pon.4886

Abstract

Objective. A dearth of studies focusing on young women (<40 years) with breast cancer have hampered the understanding of the type, prevalence, and predictors of sexual dysfunction and reproductive concerns in this population.

Methods. Data were collected from 181 women (response rate = 60%) diagnosed with breast cancer approximately 2 years previously (age 21‐39) using the Swedish National Quality Registry for Breast Cancer and a survey including standardized measures of sexual dysfunction, reproductive concerns, body image, and health‐related quality of life. Multivariable logistic binary regression analyses were used to identify predictors of sexual dysfunction and reproductive concerns.

Results. Sexual dysfunction in at least one domain was reported by 68% of the women, and a high level of reproductive concerns in at least one dimension was reported by 58%. Model results showed that current endocrine treatment was a significant predictor of dysfunction related to lubrication (OR 3.8, 95% CI 1.2‐12.1) and vaginal discomfort (OR 8.7, 95% CI 1.5‐51.5). Negative body image was related to satisfaction with sex life (OR 1.1, 95% CI 1.0‐1.2). A high level of reproductive concerns was predicted by a wish for (additional) children in the future (OR 3.4, 95% CI 1.1‐10.2) and by previous chemotherapy (OR 2.5, 95% CI 1.1‐5.9).

Conclusions. Sexual dysfunction and reproductive concerns are common in young women with breast cancer. Current endocrine treatment, previous chemotherapy, a negative body image, and a wish for children in the future predict higher level of problems.

References 39

  1. 1.

    Anders CK, Hsu DS, Broadwater G, et al. Young age at diagnosis correlates with worse prognosis and defines a subset of breast cancers with shared patterns of gene expression. J Clin Oncol. 2008;26(20):3324‐3330.

    Not in our library10.1200/jco.2007.14.2471

  2. 2.
    Breast Cancer in Young Women: Poor Survival Despite Intensive Treatment · 2009
    No notice
  3. 3.

    Duffy C, Allen S. Medical and psychosocial aspects of fertility after cancer. Cancer J [Internet]. 2009;15(1):27‐33.

    Not in our library10.1097/ppo.0b013e3181976602

  4. 4.

    Burwell SR, Case LD, Kaelin C, Avis NE. Sexual problems in younger women after breast cancer surgery. J Clin Oncol. 2006;24(18):2815‐2821.

    Not in our library10.1200/jco.2005.04.2499

  5. 5.

    Stead ML. Sexual dysfunction after treatment for gynaecologic and breast malignancies. Curr Opin Obstet Gynecol. 2003;15(1):57‐61.

    Not in our library10.1097/00001703-200302000-00009

  6. 6.

    Ganz PA, Greendale GA, Petersen L, Kahn B, Bower JE. Breast cancer in younger women: reproductive and late health effects of treatment. J Clin Oncol. 2003;21(22):4184‐4193.

    Not in our library10.1200/jco.2003.04.196

  7. 7.

    Vassilakopoulou M, Boostandoost E, Papaxoinis G, de La Motte Rouge T, Khayat D, Psyrri A. Anticancer treatment and fertility: effect of therapeutic modalities on reproductive system and functions. Crit Rev Oncol Hematol [Internet]. 2015;97:328‐334.

    Not in our library10.1016/j.critrevonc.2015.08.002

  8. 8.

    Benedict C, Thom B, Teplinsky E, Carleton J, Kelvin JF. Family‐building after breast cancer: considering the effect on adherence to adjuvant endocrine therapy. Clin Breast Cancer [Internet]. 2017;17(3):165‐170.

    Not in our library10.1016/j.clbc.2016.12.002

  9. 9.

    Gorman JR, Su HI, Pierce JP, Roberts SC, Dominick SA, Malcarne VL. A multidimensional scale to measure the reproductive concerns of young adult female cancer survivors. J Cancer Surviv [Internet]. 2014;8(2):218‐228.

    Not in our library10.1007/s11764-013-0333-3

  10. 10.

    Partridge AH, Gelber S, Peppercorn J, et al. Web‐based survey of fertility issues in young women with breast cancer. J Clin Oncol. 2004;22(20):4174‐4183.

    Not in our library10.1200/jco.2004.01.159

  11. 11.

    Benedict C, Thom B, Friedman DN, Pottenger E, Raghunathan N, Kelvin JF. Fertility information needs and concerns post‐treatment contribute to lowered quality of life among young adult female cancer survivors. Support Care Cancer [Internet]. 2018;26(7):2209‐2215.

    Not in our library10.1007/s00520-017-4006-z

  12. 12.

    Gorman JR, Malcarne VL, Roesch SC, Madlensky L, Pierce P. Depressive symptoms among young breast cancer survivors: the importance of reproductive concerns. Breast Cancer Res Treat. 2010;123(2):477‐485.

    Not in our library10.1007/s10549-010-0768-4

  13. 13.

    Bober SL, Sanchez Varela V. Sexuality in adult cancer survivors: challenges and intervention. J Clin Oncol. 2012;30(30):3712‐3719.

    Not in our library10.1200/jco.2012.41.7915

  14. 14.

    Howard‐Anderson J, Ganz PA, Bower JE, Stanton AL. Quality of life, fertility concerns, and behavioral health outcomes in younger breast cancer survivors: a systematic review. J Natl Cancer Inst. 2012;104(5):386‐405.

    Not in our library10.1093/jnci/djr541

  15. 15.

    Gilbert E, Ussher JM, Perz J. Sexuality after breast cancer: a review. Maturitas [Internet]. 2010;66(4):397‐407.

    Not in our library10.1016/j.maturitas.2010.03.027

  16. 16.

    Rosenberg SM, Tamimi RM, Gelber S, et al. Treatment‐related amenorrhea and sexual functioning in young breast cancer survivors. Cancer. 2014;120(15):2264‐2271.

    Not in our library10.1002/cncr.28738

  17. 17.

    Mortimer BJE, Boucher L, Baty J, Knapp DL, Ryan E, Rowland JH. Effect of tamoxifen on sexual functioning in patients with breast cancer. J Clin Oncol. 1999;17(5):1488‐1492.

    Not in our library10.1200/jco.1999.17.5.1488

  18. 18.

    Ganz PA. Impact of tamoxifen adjuvant therapy on symptoms, functioning, and quality of life. JNCI Monogr [Internet]. 2001;30:130‐134.

    Not in our library10.1093/oxfordjournals.jncimonographs.a003450

  19. 19.

    Ganz BPA, Desmond KA, Belin TR, Meyerowitz BE, Rowland JH. Predictors of sexual health in women after a breast cancer diagnosis. J Clin Oncol. 1999;17(8):2371‐2380.

    Not in our library10.1200/jco.1999.17.8.2371

  20. 20.

    Berglund G, Nystedt M, Bolund C, Sjoden PO, Rutquist LE. Effect of endocrine treatment on sexuality in premenopausal breast cancer patients: a prospective randomized study. J Clin Oncol [Internet]. 2001;19(11):2788‐2796.

    Not in our library10.1200/jco.2001.19.11.2788

  21. 21.

    Day R. Quality of life and tamoxifen in a breast cancer prevention trial: a summary of findings from the NSABP P‐1 study. Ann N Y Acad Sci [Internet]. 2001;949:143‐150.

    Not in our library

  22. 22.

    Saha P, Regan MM, Pagani O, et al. Treatment efficacy, adherence, and quality of life among women younger than 35 years in the international breast cancer study group TEXT and SOFT adjuvant endocrine therapy trials. J Clin Oncol. 2017;35(27):3113‐3122.

    Not in our library10.1200/jco.2016.72.0946

  23. 23.

    Ribi K, Luo W, Bernhard J, et al. 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. 2016;34(14):1601‐1610.

    Not in our library10.1200/jco.2015.64.8675

  24. 24.

    Wettergren L, Kent EE, Mitchell SA, et al. Cancer negatively impacts on sexual function in adolescents and young adults: the AYA HOPE study. Psychooncology. 2017;26(10):1632‐1639.

    Not in our library10.1002/pon.4181

  25. 25.

    Canada A, Schover L. The psychosocial impact of interrupted childbearing in long‐term female cancer survivors. Psychooncology. 2012;21(2):134‐143.

    Not in our library10.1002/pon.1875

  26. 26.

    Emilsson L, Lindahl B, Köster M, Lambe M, Ludvigsson JF. Review of 103 Swedish healthcare quality registries. J Intern Med. 2015;277(1):94‐136.

    Not in our library10.1111/joim.12303

  27. 27.

    Weinfurt KP, Lin L, Bruner DW, et al. Development and initial validation of the PROMIS® sexual function and satisfaction measures version 2.0. J Sex Med [Internet]. 2015;12(9):1961‐1974.

    Not in our library10.1111/jsm.12966

  28. 28.

    Flynn KE, Jeffery DD, Keefe FJ, et al. Sexual functioning along the cancer continuum: focus group results from the patient‐reported outcomes measurement information system (PROMIS™). Psychooncology. 2011;20(4):378‐386.

    Not in our library10.1002/pon.1738

  29. 29.

    Strandquist J, Eriksson L, Winterling J, et al. Translation of selected items of the PROMIS SexFS v2.0 into Swedish. In: The Second PHO Conference, October 23‐24. Copenhagen; 2016.

    Not in our library

  30. 30.

    Gorman JR, Su HI, Roberts SC, Dominick SA, Malcarne VL. Experiencing reproductive concerns as a female cancer survivor is associated with depression. Cancer. 2015;121(6):935‐942.

    Not in our library10.1002/cncr.29133

  31. 31.

    Hopwood P, Fletcher I, Lee A, Al Ghazal S. A body image scale for use with cancer patients. Eur J Cancer [Internet]. 2001;37(2):189‐197.

    Not in our library10.1016/s0959-8049(00)00353-1

  32. 32.

    Aaronson NK, Ahmedzai S, Bergman B, et al. The European organisation for research and treatment of cancer QLQ‐C30: a quality‐of‐life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993;85(5):365‐376.

    Not in our library10.1093/jnci/85.5.365

  33. 33.

    Giesinger JM, Kieffer JM, Fayers PM, et al. Replication and validation of higher order models demonstrated that a summary score for the EORTC QLQ‐C30 is robust. J Clin Epidemiol [Internet]. 2016;69:79‐88.

    Not in our library10.1016/j.jclinepi.2015.08.007

  34. 34.

    Shih CL, Chen CH, Sheu CF, Lang HC, Hsieh CL. Validating and improving the reliability of the EORTC QLQ‐C30 using a multidimensional Rasch model. Value Health [Internet]. 2013;16(5):848‐854.

    Not in our library10.1016/j.jval.2013.05.004

  35. 35.

    Flynn KE, Lindau ST, Lin L, et al. Development and validation of a single‐item screener for self‐reporting sexual problems in U.S. adults. J Gen Intern Med. 2015;30(10):1468‐1475.

    Not in our library10.1007/s11606-015-3333-3

  36. 36.

    Fobair P, Stewart SL, Chang SB, D'Onofrio C, Banks PJ, Bloom JR. Body image and sexual problems in young women with breast cancer. Psychooncology [Internet]. 2006;15(7):579‐594.

    Not in our library10.1002/pon.991

  37. 37.

    Raggio GA, Butryn ML, Arigo D, Mikorski R, Palmer SC. Prevalence and correlates of sexual morbidity in long‐term breast cancer survivors. Psychol Health [Internet]. 2014;29(6):632‐650.

    Not in our library10.1080/08870446.2013.879136

  38. 38.

    Meirow D, Nugent D. The effects of radiotherapy and chemotherapy on female reproduction. Hum Reprod Update. 2001;7(6):535‐543.

    Not in our library10.1093/humupd/7.6.535

  39. 39.

    Danielsson M, Berglund T, Forsberg M, Larsson M, Rogala C, Tydén T. Health in Sweden: the national public health report 2012. Chapter 9. Scand J Public Health. 2012;40(Suppl 9):176‐196.

    Not in our library10.1177/1403494812459600

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