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Vitorino CN, Omodei MS, de Souza RC, Nahas GP, de Araujo Brito Buttros D, Carvalho-Pessoa E, Vespoli HDL, Nahas EAP. Assessment of sexual function in postmenopausal breast cancer survivors. Sex Med 2024; 12:qfae035. [PMID: 38948072 PMCID: PMC11212005 DOI: 10.1093/sexmed/qfae035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 04/27/2024] [Indexed: 07/02/2024] Open
Abstract
Background Breast cancer (BC) is considered a risk factor for sexual dysfunction, which may be associated with the diagnosis itself or with oncological treatments. However, sexual dysfunction often remains underdiagnosed and unaddressed among BC survivors. Aim The study sought to evaluate the sexual function of postmenopausal BC survivors compared with postmenopausal women without BC. Methods This case-control study included 178 postmenopausal BC survivors (stages I-III), 45 to 70 years of age, with amenorrhea for ≥12 months and sexually active. They were compared with 178 women without BC, matched (±2 years) for age and time since menopause in a 1:1 ratio. Sexual function was evaluated using the Female Sexual Function Index (FSFI), which consists of 6 domains (desire, arousal, lubrication, orgasm, satisfaction, and pain), with a total score ≤26.5 indicating risk of sexual dysfunction. Statistical analysis included Student's t test, chi-square test, and logistic regression (odds ratio [OR]). Outcomes Evaluation of sexual function in postmenopausal women treated for BC. Results Postmenopausal BC survivors showed poorer sexual function in the desire domain (P = .002). No significant differences were observed between groups in the other FSFI domains and total score (P > .05). Postmenopausal BC survivors had a higher prevalence of risk of sexual dysfunction (64.6% with a total score ≤26.5) compared with the control group (51.6%) (P = .010). Adjusted risk analysis for age and time since menopause revealed a higher risk of sexual dysfunction in BC survivors compared with women without cancer (OR, 1.98; 95% confidence interval, 1.29-2.96; P = .007). Among BC survivors, the use of hormone therapy was associated with a higher risk of sexual dysfunction (OR, 3.46; 95% confidence interval, 1.59-7.51; P = .002). Clinical Implications Postmenopausal BC survivors should be regularly assessed before and throughout treatment to enable the early detection and diagnosis of sexual dysfunction. Strength and Limitations The main strength is that this study might contribute to a better understanding of sexual function in postmenopausal BC survivors compared with women without BC. The main limitation is that while the FSFI is a valid and reliable tool for the evaluation of female sexual function, it does not allow a comprehensive diagnosis of sexual dysfunction, as it is not applicable to partners. Conclusion Compared with postmenopausal women without BC, postmenopausal BC survivors face a higher risk of sexual dysfunction, especially when treated with adjuvant hormone therapy.
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Affiliation(s)
- Caroline Nakano Vitorino
- Graduate Program in Obstetrics and Gynecology, Medical School, São Paulo State University, Botucatu, São Paulo 18618-970, Brazil
| | - Michelle Sako Omodei
- Graduate Program in Obstetrics and Gynecology, Medical School, São Paulo State University, Botucatu, São Paulo 18618-970, Brazil
| | - Rafaela Caroline de Souza
- Graduate Program in Obstetrics and Gynecology, Medical School, São Paulo State University, Botucatu, São Paulo 18618-970, Brazil
| | - Georgia Petri Nahas
- Department of Obstetrics and Gynecology, Medical School, São Paulo State University, Botucatu, São Paulo 18618-970, Brazil
| | - Daniel de Araujo Brito Buttros
- Graduate Program in Obstetrics and Gynecology, Medical School, São Paulo State University, Botucatu, São Paulo 18618-970, Brazil
| | - Eduardo Carvalho-Pessoa
- Graduate Program in Obstetrics and Gynecology, Medical School, São Paulo State University, Botucatu, São Paulo 18618-970, Brazil
- Department of Obstetrics and Gynecology, Medical School, São Paulo State University, Botucatu, São Paulo 18618-970, Brazil
| | - Heloisa De Luca Vespoli
- Graduate Program in Obstetrics and Gynecology, Medical School, São Paulo State University, Botucatu, São Paulo 18618-970, Brazil
- Department of Obstetrics and Gynecology, Medical School, São Paulo State University, Botucatu, São Paulo 18618-970, Brazil
| | - Eliana Aguiar Petri Nahas
- Graduate Program in Obstetrics and Gynecology, Medical School, São Paulo State University, Botucatu, São Paulo 18618-970, Brazil
- Department of Obstetrics and Gynecology, Medical School, São Paulo State University, Botucatu, São Paulo 18618-970, Brazil
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Wang S, Hua Y, Zhang Y, Guo D, Tian L. Trajectories and influencing factors of social anxiety in postoperative breast cancer patients. BMC Psychiatry 2024; 24:357. [PMID: 38745124 PMCID: PMC11092189 DOI: 10.1186/s12888-024-05770-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 04/16/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Social anxiety among postoperative breast cancer patients is a prevalent concern, with its intensity fluctuating throughout the course of treatment. The study aims to describe the trajectory of social anxiety in postoperative breast cancer patients, explore the influencing factors, and provide theoretical support for the construction of future intervention programs. METHODS This study was conducted from June 2022 to January 2023, encompassing 213 breast cancer patients from three first-class hospitals in China. Data collection occurred at four distinct time points. A growth mixture model was employed to identify latent categories representing the trajectories of social anxiety changes among patients. A multiple regression analysis was utilized to explore predictive factors associated with different latent trajectory categories. RESULTS The trajectory of social anxiety changes in postoperative breast cancer patients includes five potential categories: maintaining mild social anxiety group, changing from mild to moderate social anxiety group, maintaining moderate social anxiety group, changing from moderate to severe social anxiety group, and maintaining severe social anxiety group. Cluster analysis results indicated three types: positive, negative, and low. Logistic regression analysis revealed that younger age, spouses concerned about postoperative appearance, chemotherapy with taxol-based drugs, opting for modified radical surgery or radical mastectomy surgical approaches, and breast cancer patients with negative rumination were factors that influenced patients' social anxiety (P < 0.05). CONCLUSION The trajectory of social anxiety in postoperative breast cancer patients comprises five potential categories. In clinical practice, it is essential to strengthen the management of high-risk populations susceptible to experiencing social anxiety emotions, including younger age, spouses concerned about postoperative appearance, chemotherapy with taxol-based drugs, opting for modified radical surgery or radical mastectomy surgical approaches, and breast cancer patients with negative rumination.
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Affiliation(s)
- Shaotong Wang
- The First Affiliated Hospital of Soochow University, Suzhou, 215000, China
- School of Nursing, Medical College of Soochow University, Suzhou, 215000, China
| | - Yafang Hua
- The First People's Hospital of Kunshan, Suzhou, 215000, China
| | - Yueyue Zhang
- The First Affiliated Hospital of Soochow University, Suzhou, 215000, China
| | - Daoxia Guo
- School of Nursing, Medical College of Soochow University, Suzhou, 215000, China
| | - Li Tian
- The First Affiliated Hospital of Soochow University, Suzhou, 215000, China.
- School of Nursing, Medical College of Soochow University, Suzhou, 215000, China.
- The First Affiliated Hospital of Soochow University/ School of Nursing, Medical College of Soochow University, No. 188 Shizi Road, Suzhou, 215006, China.
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Gan L, Miao YM, Dong XJ, Zhang QR, Ren Q, Zhang N. Investigation on sexual function in young breast cancer patients during endocrine therapy: a latent class analysis. Front Med (Lausanne) 2023; 10:1218369. [PMID: 37484843 PMCID: PMC10358731 DOI: 10.3389/fmed.2023.1218369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 06/21/2023] [Indexed: 07/25/2023] Open
Abstract
Backgrounds The aim of this study was to investigate the sexual function status of young breast cancer patients during endocrine therapy, identify potential categories of sexual function status, and analyze the factors affecting the potential categories of sexual function status during endocrine therapy. Methods A cross-sectional survey was conducted on 189 young breast cancer patients who underwent postoperative adjuvant endocrine therapy in Shanghai Ruijin Hospital. The latent class analysis was used to identify potential categories of patient sexual function characteristics with respect to the FSFI sex health measures. Logistic regression analysis was used to analyze the influencing factors for the high risk latent class groups. A nomogram prognostic model were then established to identify high risk patients for female sexual dysfunction (FSD), and C-index was used to determine the prognostic accuracy. Results Patients were divided into a "high dysfunction-low satisfaction" group and a "low dysfunction-high satisfaction" group depending on the latent class analysis, accounting for 69.3% and 30.7%, respectively. Patients who received aromatase inhibitors (AI) combined with ovarian function suppression (OFS) treatment (p = 0.027), had poor body-image after surgery (p = 0.007), beared heavy medical economy burden(p < 0.001), and had a delayed recovery of sexual function after surgery (p = 0.001) were more likely to be classified into the "high dysfunction-low satisfaction" group, and then conducted into the nomogram. The C-index value of the nomogram for predicting FSD was 0.782. Conclusion The study revealed the heterogeneity of sexual function status among young breast cancer patients during endocrine therapy, which may help identify high-risk patients and provide early intervention.
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Affiliation(s)
- Lu Gan
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yi-Ming Miao
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiao-Jing Dong
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qi-Rong Zhang
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qing Ren
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Nan Zhang
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Rodrigues-Machado N, Quintana MJ, Gómez-Gómez R, Bonfill-Cosp X. Sexual Function in Women with Breast Cancer: An Evidence Map of Observational Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13976. [PMID: 36360854 PMCID: PMC9654538 DOI: 10.3390/ijerph192113976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/20/2022] [Accepted: 10/22/2022] [Indexed: 06/16/2023]
Abstract
Breast cancer (BC) is the leading cause of cancer in women, and has implications for sexual function (SF). In this study, we used an evidence map to identify, describe, and organise the current available evidence regarding SF in women with BC. We searched the MEDLINE, PsycINFO, and CINAHL databases for observational studies assessing SF in women with BC published in English, Spanish, Portuguese, and French between 2000 and 2021 (sample ≥ 50 women). Of the 64 included studies (13,257 women with BC), 58 were published since 2010. Women who were married, partnered, or in relationships represented 74.1% of the entire sample. Only a single study was conducted on women representing a sexual minority. We identified 22 assessment instruments and 40 sexual dysfunction (SdF) domains. The number of publications on SF in women with BC has increased in the last 10 years, but still remains low. Some groups of women are underrepresented, and some SdF domains are underdiagnosed, with the assessment instrument used affecting which domains are studied. Women with BC need to be better screened, as their quality of life (QoL) is affected by SdF.
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Affiliation(s)
- Nelson Rodrigues-Machado
- Department of Paediatrics, Obstetrics & Gynaecology and Preventive Medicine, Universtitat Autònoma de Barcelona, 08193 Bellaterra, Spain
- Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain
| | - M. Jesús Quintana
- Department of Paediatrics, Obstetrics & Gynaecology and Preventive Medicine, Universtitat Autònoma de Barcelona, 08193 Bellaterra, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau), 08041 Barcelona, Spain
- Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain
- Centro Cochrane Iberoamérica, 08025 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | | | - Xavier Bonfill-Cosp
- Department of Paediatrics, Obstetrics & Gynaecology and Preventive Medicine, Universtitat Autònoma de Barcelona, 08193 Bellaterra, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau), 08041 Barcelona, Spain
- Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain
- Centro Cochrane Iberoamérica, 08025 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
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Men's experiences of sex and intimacy after prostate cancer treatment in China: a qualitative study. Support Care Cancer 2021; 30:3085-3092. [PMID: 34853913 PMCID: PMC8635323 DOI: 10.1007/s00520-021-06720-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 11/22/2021] [Indexed: 11/25/2022]
Abstract
Purpose While the existing knowledge base on the impact of prostate cancer (PC) and its treatment on sexuality and intimacy has been generated from Western populations, there is a lack of such evidence in the Asian context. This study aimed to explore men’s experiences of sex and intimacy after PC treatment in China. Methods This study adopted an interpretive descriptive design. Using purposive sampling, 13 PC patients were selected from a urology outpatient unit of a hospital in South China and proceeded with individual semi-structured telephone interviews. Each interview was transcribed verbatim and analyzed using constant comparison analysis. Results Four themes emerged from the interview data, including (a) encountering altered sexuality, (b) communication and sexual adjustments, (c) maintenance of quality intimate relationship, and (d) lack of sexual health support. Conclusions The findings revealed that PC treatment significantly impaired patients’ sexual functions, and their sexual health needs were mainly unmet by healthcare providers. There is a great need to design culturally relevant interventions to improve sexual health among this population. Supplementary Information The online version contains supplementary material available at 10.1007/s00520-021-06720-w.
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Xu J, Wang X, Chen M, Shi Y, Hu Y. Family interaction among young Chinese breast cancer survivors. BMC FAMILY PRACTICE 2021; 22:122. [PMID: 34154539 PMCID: PMC8218435 DOI: 10.1186/s12875-021-01476-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 05/24/2021] [Indexed: 12/29/2022]
Abstract
Background Family interaction is an important factor contributing to the quality of survivorship among breast cancer survivors. The dearth of studies involving young females with breast cancer has limited the understanding of family interaction in this increasingly large population. Methods The aim of this study was to explore family interaction patterns among young Chinese breast cancer survivors. We conducted in-depth interviews with seventeen young breast cancer survivors (YBCSs) in China between May 2019 and December 2019. A content analysis was performed to identify the characteristics of family interaction in this population. Conceptualizations of feminism and social support were used to guide the data analysis. Results Family interaction patterns were categorized into 5 domains from the perceptions of Chinese YBCSs: (1) adjustment of parenthood (changes in child-rearing approaches, perception of children’s care) (2) ambivalence towards intimacy (desire for intimate relationships, perceived relationship insecurity); (3) concerns regarding fertility; (4) return to work (coping with gratitude and guilt by working, readapting to family and society by working); (5) activation of the support system in a large family (instrumental support from core family members, instrumental, informational, and appraisal support from relatives). Conclusions The study provides a deeper understanding of the interactions between young breast cancer survivors and their family members in China. These findings can support health professionals in developing female-sensitive, culturally specific interventions to assist Chinese YBCSs and their families in increasing positive interactions and family resilience as well as quality of life. In addition, the findings are highly applicable to other female cancer survivors and their vulnerable families exposed to similar social and cultural contexts. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-021-01476-y.
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Affiliation(s)
- Jiehui Xu
- Department of Breast Surgery, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiyi Wang
- School of Nursing, Shanghai Jiao Tong University, 227 South Chongqing road, Huangpu, Shanghai, 200025, China
| | - Mengjie Chen
- School of Nursing, Shanghai Jiao Tong University, 227 South Chongqing road, Huangpu, Shanghai, 200025, China
| | - Yiwen Shi
- Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yun Hu
- School of Nursing, Shanghai Jiao Tong University, 227 South Chongqing road, Huangpu, Shanghai, 200025, China.
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