Andersen Barbara L, Carpenter Kristen M, Yang Hae-Chung, Shapiro Charles L
Department of Psychology, Division of Hematology/Oncology, College of Medicine, and the Comprehensive Cancer Center, Ohio State University, Columbus, OH, USA.
J Clin Oncol. 2007 Jul 20;25(21):3151-7. doi: 10.1200/JCO.2006.09.6958.
A woman's risk for sexual disruption after breast cancer recurrence has received little clinical or research attention.
Breast cancer patients recently diagnosed with recurrence (n = 60) were initially assessed at baseline and completed follow-ups at 4, 8, and 12 months. They were compared by age, stage, and duration and frequency of follow-up with matched patients who remained disease free (n = 120). Using linear mixed modeling, the groups were compared in their trajectories of change on measures of sexuality, relationship satisfaction, cancer-specific stress, and physical functioning. Recurrence subgroups, those with locoregional versus distant disease and those younger versus older than 52 years, were also compared.
At baseline, the recurrence group had significantly lower intercourse frequency and physical functioning compared with the disease-free group and these differences were maintained. There were no significant differences in the frequencies of kissing or sexual and relationship satisfactions. For the recurrence group patients, the heightened stress of the diagnostic/early recurrence treatment period declined to the lower disease-free levels by 12 months. This effect was largely due to improvement of the patients with distant disease. Finally, sexual changes were most notable for younger patients.
To our knowledge, this is the first longitudinal, controlled study of sexuality-sexuality in the context of other quality of life domains-for women coping with recurrence. Despite disruption, patients maintained their sexual lives. Younger and distant recurrence patients, however, may have greatest risk of sexual disruption. The factors contributing to sexual disruption remain unknown, and studies investigating strategies to help patients maintain this aspect of quality of life are needed.
乳腺癌复发后女性性功能障碍的风险在临床和研究方面都很少受到关注。
最近被诊断为复发的乳腺癌患者(n = 60)在基线时进行了初步评估,并在4个月、8个月和12个月时完成了随访。将他们与病情无复发的匹配患者(n = 120)按年龄、分期、随访持续时间和频率进行比较。使用线性混合模型,比较两组在性功能、关系满意度、癌症特异性压力和身体功能测量指标上的变化轨迹。还比较了复发亚组,即局部区域疾病与远处疾病患者以及年龄小于52岁与大于52岁的患者。
在基线时,复发组的性交频率和身体功能明显低于无病组,且这些差异持续存在。在亲吻频率或性及关系满意度方面没有显著差异。对于复发组患者,诊断/早期复发治疗期加剧的压力在12个月时降至无病组的较低水平。这种效应主要归因于远处疾病患者的改善。最后,年轻患者的性变化最为显著。
据我们所知,这是第一项针对应对复发的女性在其他生活质量领域背景下进行的关于性方面的纵向对照研究。尽管受到干扰,患者仍维持其性生活。然而,年轻患者和远处复发患者可能面临性功能障碍的最大风险。导致性功能障碍的因素仍然未知,需要开展研究以探讨帮助患者维持这一生活质量方面的策略。