Sexual function and chemotherapy in postmenopausal women with breast cancer

José Antônio Crespo Cavalheiro, Anacristinadacosta Bittelbrunn, Carlos Henrique Menke, Jorge Villanova Biazús, Nilton Leite Xavier, Rodrigo Cericatto, Fernando Schuh, Caroline Vieira Pinheiro, Eduardo Pandolfi Passos, José Antônio Crespo Cavalheiro, Anacristinadacosta Bittelbrunn, Carlos Henrique Menke, Jorge Villanova Biazús, Nilton Leite Xavier, Rodrigo Cericatto, Fernando Schuh, Caroline Vieira Pinheiro, Eduardo Pandolfi Passos

Abstract

Background: This cross-sectional, nested cohort study assessed Female Sexual Function Index (FSFI) scores in postmenopausal women with breast cancer receiving primary chemotherapy.

Methods: The FSFI questionnaire was administered to 24 postmenopausal women one month after diagnosis of breast cancer (post-diagnosis group) and one month after completion of the first cycle of primary anthracyclin-based chemotherapy (post-chemotherapy group). Scores were compared to those of 24 healthy postmenopausal women seeking routine gynecological care (control group). All patients were sexually active at the time of enrollment. Mean age was 57.29 ± 11.82 years in the breast cancer group and 52.58 ± 7.19 years in the control group.

Results: Scores in all domains of the FSFI instrument were significantly lower in the post-diagnosis group than in controls (-41.3%, p < 0.001). A further major reduction in FSFI scores was evident on completion of one cycle of primary chemotherapy (down 46.7% from post-diagnosis scores, p < 0.003), again in all domains. Six patients (25%) ceased all sexual relations, in a significant change from baseline (p < 0.001). After one chemotherapy cycle, a further five patients ceased sexual activity, for a total of 11 (45.8%) participants--a borderline significant difference (p = 0.063).

Conclusion: The present study shows that female sexual function as assessed by the FSFI declines significantly at two distinct points in time: upon diagnosis of breast cancer and after administration of systemic chemotherapy.

References

    1. Conde DM, Pinto-Neto AM, Cabello C. et al.Quality of life in Brazilian breast cancer survivors age 45–65 years: associated factors. Breast J. 2005;11:425–432. doi: 10.1111/j.1075-122X.2005.00124.x.
    1. Menke CH, Pohlmann PR, Backes A. et al.A Tumor size as a surrogate end point for the detection of early breast cancer: a 30-year (1972–2002), single-center experience in southern Brazil. Breast J. 2007;13:448–5. doi: 10.1111/j.1524-4741.2007.00464.x.
    1. INCA Instituto Nacional do Câncer [Internet] Brasília: Ministério da Saúde. [cited 2010 Aug 17] Câncer da mama feminina. Variação percentual anual estimada. , Brasil; 2010. Available from: .
    1. Hentschel H. In: Rotinas em ginecologia. Freitas FM, Menke CH, Rivoire WA, editor. Artmed, Porto Alegre; 2001. Sexualidade Humana; pp. 231–241.
    1. Couzi RJ, Helzlsouer KJ, Fetting JH. Prevalence of menopausal symptoms among women with a history of breast cancer and attitudes toward estrogen replacement therapy. J Clin Oncol. 1995;13:2737–2744.
    1. Rabin EG, Heldt E, Hirakata VN, Fleck MP. Quality of life predictors in breast cancer women. Eur J Oncol Nurs. 2008;1:53–57.
    1. Speer JJ, Hillenberg B, Sugrue DP. et al.Study of sexual functioning determinants in breast cancer survivors. Breast J. 2005;6:440–447.
    1. Hentschel H, Alberton DL, Sawdy RJ. et al.Sexual function in women from infertile couples and in women seeking surgical sterilization. J Sex Marital Ther. 2008;2:107–114.
    1. Rosen R, Brown C, Heiman J. et al.The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther. 2000;2:191–208.
    1. Menke CH. Rotinas em Mastologia. ArtMed, Porto Alegre; 2006.
    1. Zubrod CG, Schneiderman M, Frei E. et al.Appraisal of methods for the study of chemotherapy of cancer in man: comparative therapeutic trial of nitrogen mustard and triethylene thiophosphoramide. J Chron Diseases. 1960;11:7–33. doi: 10.1016/0021-9681(60)90137-5.
    1. Polinski GE, Burbie ML. Intimacy and sexuality after cancer treatment. J Psychosocial Oncol. 1992;10:19–33. doi: 10.1300/J077v10n01_03.
    1. Sheppard LA, Ely S. Breast Cancer and Sexuality. The Breast Journal. 2008;14(2):176–181. doi: 10.1111/j.1524-4741.2007.00550.x.
    1. Anilo L. Sexual life after breast cancer. J Sex Marital Ther. 2000;26:241–248. doi: 10.1080/00926230050084632.
    1. Ganz PA, Desmond KA, Leedham B. et al.Quality of life in long-term, disease-free survivors of breast cancer: a follow-up study. J Natl Cancer Inst. 2002;94:39–49. doi: 10.1093/jnci/94.1.39.
    1. Ganz PA, Desmond KA, Belin TR, Meyerowitz BE, Rowland JH. Predictors of sexual health in women after a breast cancer diagnosis. J Clin Oncol. 1999;17:2371–2380.
    1. Grem JL, Carvalho M, Wittes RE, Allegra CJ. In: Manual of Oncologic Therapeutics. Macdonald JS, Haller DG, Mayer RJ, editor. Lippincott Williams & Wilkins, Philadelphia, PA; 1995. Chemotherapy: the properties and uses of single agents; pp. 80–137.
    1. Henson HK. Breast cancer and sexuality. Sex Disabil. 2002;20:261–275. doi: 10.1023/A:1021657413409.
    1. McInnes RA. Chronic illness and sexuality. Med J Australia. 2003;179(5):263–266.
    1. Payne DK, Sullivan MD, Massie MJ. Women’s psychological reactions to breast cancer. Semin Oncol. 1996;23:89.
    1. Schnipper HH. Life after breast cancer. J Clin Oncol. 2001;19:3581–3584.
    1. Ananth H, Jones L, King M, Tookman A. The impact of cancer on sexual. Med J Aust. 2003;179(5):263–266.
    1. Broeckel JA, Jacobsen PB, Balducci L. et al.Quality of life after adjuvant chemotherapy for breast cancer. Breast Cancer Res Treat. 2000;62:141–145. doi: 10.1023/A:1006401914682.
    1. Joly F, Espie M, Marty M, Heron JF, Henry-Amar M. Long-term quality of life in premenopausal women with node-negative localized breast cancer treated with or without adjuvant chemotherapy. Br J Cancer. 2000;83:577–582. doi: 10.1054/bjoc.2000.1337.
    1. Sheppard LA, Ely S. Breast Cancer and Sexuality. The Breast Journal. 2008;14(2):176–181. doi: 10.1111/j.1524-4741.2007.00550.x.
    1. Schover LR. The impact of breast cancer on sexuality, body image and intimate relationships. CA Cancer J Clin. 1991;41:112–120. doi: 10.3322/canjclin.41.2.112.
    1. Cort E, Monroe B, Oliviere D. Couples in palliative care. Sex Marital Ther. 2004;19:337–354.
    1. Tsimtsiou Z, Hatzimouratidis K, Nakopoulou E. et al.Predictors of physicians' involvement in addressing sexual health issues. J Sex Med. 2006;3:583–588. doi: 10.1111/j.1743-6109.2006.00271.x.

Source: PubMed

3
订阅