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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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Pennycuff JF, Desale S, Wang H, Zhang G, Richter LA. Prevalence of pelvic floor disorders, associations of endocrine therapy, and surgical intervention among breast cancer survivors. Int Urogynecol J 2022; 33:2421-2426. [PMID: 35788699 DOI: 10.1007/s00192-022-05271-w] [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: 02/10/2022] [Accepted: 05/22/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION AND HYPOTHESIS To evaluate prevalence of pelvic floor disorders, association of endocrine therapy with pelvic floor disorders, and rates of pelvic floor surgery among breast cancer survivors compared to matched controls without history of cancer. METHODS This is a retrospective, cohort study using electronic medical record data from a ten-hospital regional healthcare system. A total of 19,483 women diagnosed with breast cancer between January 2008 and April 2020 were propensity score matched to 19,483 women without a history of cancer. Medical charts were abstracted for ICD-9 and ICD-10 codes for pelvic floor disorders, use of endocrine therapy, and CPT codes for pelvic floor surgeries and procedures. RESULTS Overall, the prevalence of pelvic floor disorders was lower among breast cancer survivors (8.8% vs. 22.6%, p < 0.001), and mean time to development of pelvic floor disorders among breast cancer survivors was 3 years. Selective estrogen receptor modulators and aromatase inhibitors were associated with pelvic organ prolapse and stress urinary incontinence, while estrogen antagonists were associated with urge urinary incontinence and lower urinary tract symptoms. Women with breast cancer had similar or higher rates of pelvic floor surgery compared to matched controls. CONCLUSIONS Rates of pelvic floor disorders were lower among breast cancer survivors compared to controls but rates of surgical intervention did not differ and were higher for some conditions among breast cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS Screening for these disorders should be considered as part of routine survivorship care.
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Affiliation(s)
- Jon F Pennycuff
- Division of Female Pelvic Medicine and Reconstruction Surgery, Department of Obstetrics and Gynecology, University of Wisconsin, 202 S. Park St. 2E, Madison, WI, 53715, USA.
| | - Sameer Desale
- Medstar Health Research Institute, 6526 Belcrest Rd., Hyattsville, MD, 20782, USA
| | - Haijun Wang
- Medstar Health Research Institute, 6526 Belcrest Rd., Hyattsville, MD, 20782, USA
| | - Gongliang Zhang
- Medstar Health Research Institute, 6526 Belcrest Rd., Hyattsville, MD, 20782, USA
| | - Lee A Richter
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Medstar Washington Hospital Center/Georgetown University School of Medicine, 106 Irving St. NW, Washington, DC, 20010, USA
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Ribi K, Luo W, Walley BA, Burstein HJ, Chirgwin J, Ansari RH, Salim M, van der Westhuizen A, Abdi E, Francis PA, Chia S, Harvey VJ, Giobbie-Hurder A, Fleming GF, Pagani O, Di Leo A, Colleoni M, Gelber RD, Goldhirsch A, Coates AS, Regan MM, Bernhard J. Treatment-induced symptoms, depression and age as predictors of sexual problems in premenopausal women with early breast cancer receiving adjuvant endocrine therapy. Breast Cancer Res Treat 2020; 181:347-359. [PMID: 32274665 DOI: 10.1007/s10549-020-05622-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 03/29/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE Sexual dysfunction is an important concern of premenopausal women with early breast cancer. We investigated predictors of sexual problems in two randomized controlled trials. METHODS A subset of patients enrolled in TEXT and SOFT completed global and symptom-specific quality-of-life indicators, CES-Depression and MOS-Sexual Problems measures at baseline, six, 12 and 24 months. Mixed models tested the association of changes in treatment-induced symptoms (baseline to 6 months), depression at 6 months, and age at randomization with changes in sexual problems over 2 years. RESULTS Sexual problems increased by 6 months and persisted at this level. Overall, patients with more severe worsening of vaginal dryness, sleep disturbances and bone or joint pain at 6 months reported a greater increase in sexual problems at all time-points. Depression scores were significantly associated with sexual problems in the short-term. All other symptoms had a smaller impact on sexual problems. Age was not associated with sexual problems at any time-point. CONCLUSION Among several key symptoms, vaginal dryness, sleep disturbance, and bone and joint pain significantly predicted sexual problems during the first 2 years. Early identification of these symptoms may contribute to timely and tailored interventions.
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Affiliation(s)
- Karin Ribi
- International Breast Cancer Study Group (IBCSG) Coordinating Center, Effingerstrasse 40, 3008, Bern, Switzerland.
| | - Weixiu Luo
- IBCSG Statistical Center, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Barbara A Walley
- University of Calgary and Canadian Cancer Trials Group, Calgary, AB, Canada
| | - Harold J Burstein
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Jacquie Chirgwin
- Box Hill and Maroondah Hospitals, Monash University, Clayton, VIC, Australia.,Breast Cancer Trials Australia & New Zealand, University of Newcastle, Callaghan, Australia
| | - Rafat H Ansari
- Norther Indiana Cancer Research Consortium, South Bend, USA
| | | | - Andre van der Westhuizen
- Breast Cancer Trials Australia & New Zealand, University of Newcastle, Callaghan, Australia.,Calvary Mater Newcastle Hospital, Waratah, NSW, Australia
| | - Ehtesham Abdi
- The Tweed Hospital, Griffith University Gold Coast, Tweed Heads, NSW, Australia
| | - Prudence A Francis
- Breast Cancer Trials Australia & New Zealand, University of Newcastle, Callaghan, Australia.,Peter MacCallum Cancer Center, St Vincent's Hospital, University of Melbourne, Melbourne, Australia
| | - Stephen Chia
- BCCA-Vancouver Cancer Center, Vancouver, BC, Canada
| | | | | | - Gini F Fleming
- The University of Chicago Medical Center, Chicago, IL, USA
| | - Olivia Pagani
- Institute of Oncology of Southern Switzerland, Geneva University Hospitals, Swiss Group for Clinical Cancer Research (SAKK), Lugano Viganello, Switzerland
| | - Angelo Di Leo
- Hospital of Prato-AUSL Toscana Centro and International Breast Cancer Study Group, Prato, Italy
| | | | - Richard D Gelber
- IBCSG Statistical Center, Dana-Farber Cancer Institute, Boston, MA, USA.,Harvard Medical School, Harvard University, Boston, MA, USA.,Harvard TH Chan School of Public Health, Frontier Science and Technology Research Foundation, Boston, MA, USA
| | - Aron Goldhirsch
- International Breast Cancer Study Group (IBCSG) Coordinating Center, Effingerstrasse 40, 3008, Bern, Switzerland.,MultiMedica, Milan, Italy
| | - Alan S Coates
- International Breast Cancer Study Group (IBCSG) Coordinating Center, Effingerstrasse 40, 3008, Bern, Switzerland.,University of Sydney, Sydney, Australia
| | - Meredith M Regan
- IBCSG Statistical Center, Dana-Farber Cancer Institute, Boston, MA, USA.,Harvard Medical School, Harvard University, Boston, MA, USA
| | - Jürg Bernhard
- International Breast Cancer Study Group (IBCSG) Coordinating Center, Effingerstrasse 40, 3008, Bern, Switzerland.,Bern University Hospital, Inselspital, Bern, Switzerland
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Imamoglu GI, Eren T, Arzu O, Yıldırım N, Karacin C, Baylan B. Is Tamoxifen Use a Factor Affecting Continence in Breast Cancer Patients? Cureus 2019; 11:e5417. [PMID: 31632870 PMCID: PMC6795370 DOI: 10.7759/cureus.5417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Tamoxifen treatment has been shown to reduce the recurrence and mortality rates in hormone receptor-positive breast cancers independent from chemotherapy. This benefit increases with the prolongation of the use of tamoxifen but with increasing side effects. In this study, we aim to evaluate the presence of urogenital symptoms in breast cancer patients on tamoxifen and compare them with those who are not on any hormonotherapy. MATERIALS AND METHODS This study was performed on patients diagnosed as early-stage breast cancer. The study group consisted of hormone receptor-positive patients given tamoxifen as adjuvant hormonal therapy. The control group consisted of breast cancer patients who had no hormonotherapy. Patients with a complaint of urinary incontinence with onset after tamoxifen usage were evaluated with Urogenital Distress Inventory Short Form (UDI-6), Incontinence Impact Questionnaire Short Form (IIQ-7) and Incontinence Quality of Life Questionnaire (I-QOL). RESULTS A total of 137 early-stage breast cancer patients were included in this study; 74 estrogen receptor-positive patients on tamoxifen therapy (study group) and 63 hormone receptor-negative patients with no hormonotherapy (control group). The median age was 44 (30-65) years for tamoxifen users and 49 (27-64) years for the control group. The stages of the patients were similar for both groups. 78.4% of the women in the tamoxifen group and 49.2% in the control group were in the premenopausal period. The groups were similar in regard to body mass index and parity. The complaint of urinary incontinence was more frequent in the study group compared to controls (39 (52.7%) vs. 5 (7.9%)). Women with the complaint of urinary incontinence were evaluated with self-reported UDI-6, IIQ-7 and I-QOL forms and the scores were similar for both study and control groups. A statistically significant relation was observed between cigarette smoking and the presence of urinary incontinence. The percentages of smokers were 50% of those with incontinence and 24.7% of those without incontinence. CONCLUSION Urinary incontinence is positively correlated with tamoxifen usage in early-stage breast cancer patients.
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Affiliation(s)
| | - Tulay Eren
- Oncology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, TUR
| | - Oguz Arzu
- Oncology, Baskent University Faculty of Medicine, Ankara, TUR
| | - Nuriye Yıldırım
- Oncology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, TUR
| | - Cengiz Karacin
- Oncology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, TUR
| | - Burhan Baylan
- Urology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, TUR
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Qureshi AA, Sharma K, Thornton M, Myckatyn TM, Tenenbaum MM. Vaginal Laxity, Sexual Distress, and Sexual Dysfunction: A Cross-Sectional Study in a Plastic Surgery Practice. Aesthet Surg J 2018; 38:873-880. [PMID: 29370358 DOI: 10.1093/asj/sjx255] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Sexual health issues can be characterized by vaginal laxity (VL), sexual distress, and sexual dysfunction. The epidemiology of these issues in plastic surgery patients, and especially breast cancer survivors, remains poorly understood. OBJECTIVES To prospectively assess sexual health issues in a plastic surgery patient population with and without breast cancer. METHODS A prospective cohort study was created in our practice from June to August 2017 with administration of a survey including the vaginal laxity questionnaire (VLQ), female sexual distress scale-revised (FSDS-R), and female sexual function index (FSFI). Multivariate logistic regression identified the controlled effect of patient variables on development of sexual health issues. RESULTS Of 291 patients solicited, 239 completed the survey (37.7% breast cancer survivors vs 62.3% without). Prevalence of VL was nearly 1 in 6 women. Of these, 46.0% met criteria for sexual distress (FSDS-R ≥ 11.0) and 64.8% had sexual dysfunction (FSFI ≤ 26.5). Breast cancer survivors exhibited significantly greater overall sexual dysfunction (P < 0.001) and greater dysfunction within all FSFI domains of desire, arousal, lubrication, orgasm, satisfaction, and pain (all P < 0.02). On multivariate regression, number of vaginal deliveries predicted development of VL (OR 1.87, P < 0.001), presence of VL predicted sexual distress (OR 3.01, P = 0.007), while history of breast cancer predicted sexual dysfunction (OR 1.87, P < 0.05). CONCLUSIONS Sexual health issues are prevalent amongst plastic surgery patients. Aesthetic practices can improve patients' quality of life by focusing on these areas. Potential therapeutic options to address sexual health issues should consider addressing vaginal laxity. LEVEL OF EVIDENCE 2
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Affiliation(s)
- Ali A Qureshi
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO
| | - Ketan Sharma
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO
| | | | - Terence M Myckatyn
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO
| | - Marissa M Tenenbaum
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO
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