Impact of Breast Cancer Treatment on Female Sexual Function: A Systematic Review

Abstract

INTRODUCTION: Breast cancer (BC) is the most common cancer in women worldwide and, nowadays, advances in BC screening and treatments have led to increasing rates of survival. This factor leads to a special concern about this women’s quality of life and among them, the sexuality. Sexual changes can become the most problematic aspect of a woman’s life. The impact of such changes can last for many years after successful treatment, and can be associated with serious physical and emotional side-effects. The aim of this study was to identify the most common type of female sexual dysfunction (FSD) after the treatment for BC. METHODS: It was performed a systematic review of studies published in the literature until July 2012 in the following database: MEDLINE, Pubmed, SciELO e Lilacs. It was used as used the descriptor: “breast cancer” associated with the following: “sexual dysfunction”, “sexual function” and “sexuality”. It were included studies which evaluated quantitatively the sexual dysfunction presence after BC treatment. It was considered sexual dysfunctions: disorders of desire, lubrication, arousal, orgasm and the presence of pain during the sexual intercourse. The exclusion criteria were narrative review, editorials, case studies and qualitative researches, because there is no objective data, making its compilation impossible. One researcher performed the studies search and two researchers, independently, evaluated the articles to be analyzed by means of structured guide with the following items: 1) sample characterizes, 2) type of treatment for BC and 3) method used to evaluate female sexual function. RESULTS: By reading the title, were chosen for inclusion in 97 articles, of which 85 were excluded after reading the abstract and another 2 were excluded after reading the entire article. It was included 10 studies which evaluated a total of 8. 465 women. The most frequent treatment for BC were: chemotherapy (100%), surgeries for BC (100%) and radiotherapy (83%). The most frequent sexual dysfunction were: decrease of desire/sexual interest (66%), difficulty in lubrication (50%), lack of arousal (33%) and pain during the sexual intercourse (11%). Other associated symptoms were described as fatigue, insomnia, physical problems, lack of satisfaction, shortness of intercourse, feeling less attractive, partner lack of understanding about their feelings and concern about partner desire/interest. DISCUSSION: in a recent study it was questioned the assessment of sexual function during a routine visits. The evidence showed that this theme approach increases the FSD diagnostic capability and improves access to treatment. Due to the high prevalence of these disorders in women who underwent treatment of BC and the various non-hormonal treatment options, it is important to underscore the tackling of this issue by Breast Cancer Specialist and/or Oncologist during consultation and forward for treatment when necessary. CONCLUSION: The FSD were identified as hypoactive sexual desire, lubrication difficult and lack of arousal. The studies demonstrated that the various treatment of BC negatively impact female sexual function.