Abstract
Sexual challenges are frequently reported by women diagnosed with breast cancer (BC), but knowledge of their long-term sexual health is limited. We aimed to compare sexual health among BC survivors (BCSs) eight years after diagnosis to that of population controls, and to explore the effects of age and systemic BC treatment. Women aged 20-65 years when diagnosed with early BC in 2011-2012 were identified by the Cancer Registry of Norway (n=2803) and invited to participate in a questionnaire survey. In total, 1241 BCSs responded and were eligible to this study. Controls were similar aged women (n=17751 of the 36395 invited) from the Trøndelag Health Study. Sexual health was measured by subscales from the EORTC QLQ-BR23 (sexual enjoyment and sexual function) scored from 0-100, and from the Sexual Activity Questionnaire (sexual discomfort) scored from 0-6. Linear regression analyzes with adjustments for sociodemographic variables were performed. Compared to similar aged controls: • Sexual enjoyment was poorer (B -14.4, CI -16.4, -12.5) and discomfort higher (B 1.0, CI 0.9, 1.1) among BCSs in total • There were no differences in sexual health when assessing BCSs diagnosed at postmenopausal age (≥ 55 years) • BCSs with current use of endocrine treatment had poorer sexual function (B -11.9, CI -14.7, -9.1), poorer enjoyment (B -17.6, CI -21.4, -13.9) and higher discomfort (B 1.4, CI 1.2, 1.7) • BCSs treated with adjuvant chemotherapy had poorer sexual function (B -11.1, CI -12.7, -9.5), poorer enjoyment (B -16.7, CI -19.0, -14.5) and higher discomfort (B 1.3, CI 1.1, 1.4) • BCSs formerly treated with aromatase inhibitor had poorer sexual function (B -10.1, CI -12.9, -7.4), poorer enjoyment (B -16.9, CI -21.0, -12.9) and higher discomfort (B 1.3, CI 1.0, 1.5). There were no differences in sexual health when comparing BCSs diagnosed at postmenopausal age with similar aged controls - a reassuring finding for postmenopausal women diagnosed with BC. Premenopausal age, adjuvant chemotherapy, current endocrine therapy, and former aromatase inhibitor therapy are risk factors for sexual health challenges in long-term BCSs. During follow-up, special attention with regards to sexual health should be given to BCSs with these risk factors.
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