Relationship Status and Operation Type Are Important Predictors of Sexual Well-Being After Breast Cancer Surgery

Abstract

INTRODUCTION: Patient, disease, and treatment factors may impact patients’ sexual wellbeing (SW) during breast cancer treatment. In this study, we evaluated the effect of relationship status and operation type on SW after breast surgery. METHODS: Newly diagnosed stage 0–III female breast cancer patients seen at an academic breast center between June 2019 and January 2021 were invited to participate in a longitudinal patient reported outcome (PRO) study. SW was measured on a 0–100 scale using the Breast-Q module, a validated PRO scale evaluating quality of life in breast cancer patients. Demographic and clinicopathologic factors were collected from patient survey responses and review of the electronic health record. Primary outcomes were SW scores at 6 months after breast operation. Groups were compared using t-tests and multiple regression models. RESULTS: Fifty-one patients completed the 6-month survey. Overall mean SW scores were 48 (SD 29). Mean SW scores were 55 (SD 28) for married or partnered women (n = 38) and 28 (SD 24) for single women (n = 13; p < 0.01). Mean SW scores were 61 (SD 25) for patients undergoing lumpectomy (n = 29) and 31 (SD 25) for patients undergoing mastectomy (n = 22; p < 0.01). In the multiple regression (Table), being single (Beta = –30; 95% CI –45 to –14) and undergoing mastectomy (Beta = –46; 95% CI –75 to –17) were associated with severely diminished SW scores. CONCLUSION: Patients who are single and who undergo mastectomy are at high risk for worse sexual wellbeing. Early intervention should be provided to these patients to mitigate these outcomes and improve sexual health. Table. - Multiple Regression Model for Sexual Well-Being Score at 6 Months after Operation Variable Beta coefficient Significance (p Value) 95% CI for beta lower bound 95% CI for beta upper bound Bachelor’s degree or higher 10.103 .156 −4.022 24.228 Single, divorced, or widowed −29.575 ≤.001 −45.089 −14.061 Pathologic stage −1.158 .721 −7.681 5.365 Mastectomy −45.783 .003 −74.658 −16.908 Reconstruction 17.607 .135 −5.720 40.934 Axillary lymph node dissection 5.662 .648 −19.259 30.583 Postmenopausal 13.883 .020 2.293 25.473 Adjuvant chemotherapy -6.641 .376 -21.654 8.372 Adjuvant radiation -8.831 .385 -29.160 11.498