(113) PRACTICAL DISTRESS AT DIAGNOSIS PORTENDS WORSE SEXUAL WELL-BEING DURING BREAST CANCER TREATMENT

Abstract

Abstract Introduction A breast cancer diagnosis and subsequent treatment can have profound impacts on patients' body image and sexual health. Sexual health and well-being are an unmet concern for many and declines in sexual function have been associated with higher distress and anxiety. Objective Our study aims to evaluate how distress at diagnosis is related to sexual well-being and referral to ancillary resources during breast cancer treatment at a comprehensive cancer center. Methods All patients with newly diagnosed breast cancer were offered a distress screening tool which measures distress in the emotional (I.e. worry, nervousness), physical (I.e. nausea, sexual intimacy, fatigue), social (I.e. relating with others), and practical domains (I.e. bills, housing, transportation). High distress in a domain was defined as a score greater than 5. Patients were then invited to complete the Breast-Q module, a validated patient reported outcome (PRO) scale that quantifies outcomes related to sexual well-being (SW). Participants who had at least one distress measure at baseline and at least one PRO at either baseline or 6-months post-operatively were eligible for inclusion. Chart review was conducted for referral to and utilization of ancillary services including sexual health consultation. Multivariable linear mixed models were used to compare high and low distress with an interaction between distress and time. Results 227 patients were included in the study population. The median baseline SW score was 55.4 (standard deviation = 22.9). High practical distress was found in 18.4% of patients, however, those with high practical distress at baseline were more likely to have greater decline in their SW scores between the pre-operative and 6-month post-operative time points (p = 0.03) (Figure 1). After adjusting for age, stage, and treatment received, this relationship remained significant. Of the available ancillary resources, social work and care management services were the most common referrals with 135 patients seen. Only 4 patients attended a sexual health consultation based on clinician discretion. Change in pre-operative and 6-month post operative SW was not related to emotional, physical, or social distress. Conclusions Sexual well-being trajectories are related to practical distress at diagnosis. This suggests that patients who are already struggling with the logistics of a new breast cancer diagnosis may suffer the most when it comes to their sexual health. Most patients here received some ancillary support however it is clear something is still missing given the observed declines in sexual well-being. Further study is necessary to understand the drivers of this relationship and how these patients can receive early intervention to prevent worsening of their sexual well-being during breast cancer treatment. Disclosure No.