Body Image, Sexual Function and Satisfaction in Women with Breast Cancer

Abstract

BACKGROUND: The diagnosis of breast cancer includes not only physical but also social and psychological factors that also influence body image and sexuality of women. MATERIAL AND METHODS: We performed an observational cross-sectional study with 77 women over 18 years of age and who had completed radiation therapy and/or chemotherapy. The socialdemographic and clinical data were obtained through a clinical assessment form and the clinical data from medical records. We used the subscales of the EORTC QLQ BR 23 questionnaire to assess body image, sexual desire, sexual frequency and satisfaction. RESULTS: 59. 8% of the women are aged between 40 and 59. 66. 2% are housewives and/or retired.57. 1% have no partner and 53. 2% have only primary education. Regarding clinical data, 90. 9% had 10 or more lymph nodes dissected and 46% had no lymph nodes. 66. 2% underwent conservative surgery and only two patients (2. 6%) underwent breast reconstruction. The main therapeutics used were radiotherapy (90. 9%) and/or chemotherapy (87%). The seroma formation was the most frequent postoperative complication (46. 8%), followed by dehiscense (23. 4%). Low scores were observed regarding body image (63.57), sexual desire (34. 63), sexual frequency (32. 03) and sexual satisfaction (45. 91). Younger women with no partner and with a higher educational level had higher sexual desire (p <0. 001, p <0. 001 and p = 0. 006 respectively) and higher sexual frequency (p = 0. 027, p <0. 001 and p = 0. 023 respectively). There was no correlation between body image and the context of sexual activity. DISCUSSION: Conservative surgery prevailed and the age group data show women in a highly productive age. However, their body image is changed. Low scores related to sexual desire, sexual frequency and satisfaction were observed. According to Santos and Vieira (2011) breast surgery, whether conservative or not, as well as other treatments interferes on body image and sexuality. It is observed that the fact of having cancer alters the woman’s perception of herself as a woman and that the breast is the organ that is mostly associated with femininity and sexuality (BERTERO, 2002, GOMES et al, 2002, VAZIRI and KASHANI 2012). Younger women, with no partner and with higher education levels had better sexual function. These results are corroborated by Rebelo et al (2007). Other studies, however, show that younger women with no partners had worse scores in relation to sexuality (HUGUET et al, 2009, GANZ et al, 2003). CONCLUSION: The body image and sexuality of those women are altered. Younger women with no partners and with more schooling have better sexual functioning. For professionals, these data represent a challenge both in evaluation and in the assessment of strategies that address body image and sexual function.