Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, Crosstown Center, Boston, MA 02118, USA.
J Cancer Surviv. 2013 Jun;7(2):203-10. doi: 10.1007/s11764-012-0260-8. Epub 2013 Jan 18.
Because little is known about morbidity and symptoms among sexual minority women with breast cancer, that is, lesbian or bisexual-identified women, and women with a preference for a woman partner, we examined differences by sexual orientation in long-term survivors' symptoms and morbidity, considering arm morbidity, systemic therapy side effects, hypertension, and number of comorbidities.
From a state cancer registry, we recruited 257 heterosexual and 69 sexual minority women (SMW) with a diagnosis of primary, nonmetastatic breast cancer. To increase the number of SMW, we used convenience recruitment methods and obtained an additional 112 SMW who fit the same eligibility criteria as the registry-derived sample. Using a telephone survey, we collected demographic and self-reported data on arm morbidity and systematic therapy side effects, using the European Organization for Research and Treatment of Cancer Quality of Life scale, QLQ-BR23 and a comorbidity measure developed for breast cancer survivors.
Sexual orientation was more strongly associated with arm morbidity and systemic side effects than with high blood pressure and comorbidities. Sexual orientation related indirectly to systemic side effects and arm morbidity through cancer treatments and some demographic factors.
Our finding that SMW respond more negatively to certain cancer treatments compared to heterosexual women suggests an opportunity to intervene with education and support for SMW breast cancer survivors for whom these life-saving treatments are necessary.
Because breast cancer survivors are at risk for multiple severe and persistent symptoms, assessing such symptoms is an important aspect of survivorship care. Cultural differences in perception of symptoms, communication issues, cultural barriers to reporting of symptoms, and different cultural norms about expressing pain or impairments have been established by studies. Knowledge about differences in impairment and symptoms by sexual orientation will help providers' efforts to provide high quality care to breast cancer survivors and may enhance cancer survivorship.
由于鲜少有人了解患有乳腺癌的性少数群体女性（即女同性恋或双性恋女性，以及偏好女性伴侣的女性）的发病率和症状，因此我们研究了不同性取向的长期生存者在手臂发病率、全身治疗副作用、高血压和合并症数量方面的症状和发病率差异。
我们从州癌症登记处招募了 257 名异性恋和 69 名性少数群体女性（SMW），这些女性均被诊断为原发性、非转移性乳腺癌。为了增加 SMW 的数量，我们采用了便利招募方法，并招募了另外 112 名符合登记处样本相同资格标准的 SMW。我们通过电话调查收集了手臂发病率和全身治疗副作用的人口统计学和自我报告数据，使用欧洲癌症研究和治疗组织生活质量量表（QLQ-BR23）和为乳腺癌幸存者开发的合并症测量工具。
与高血压和合并症相比，性取向与手臂发病率和全身副作用的相关性更强。性取向通过癌症治疗和一些人口统计学因素与全身副作用和手臂发病率间接相关。
我们发现，与异性恋女性相比，SMW 对某些癌症治疗的反应更为负面，这表明有机会通过教育和支持来干预需要这些救命治疗的 SMW 乳腺癌幸存者。
由于乳腺癌幸存者面临多种严重且持续的症状，因此评估这些症状是生存护理的一个重要方面。研究已经确定了在症状感知、沟通问题、报告症状的文化障碍以及表达疼痛或损伤的不同文化规范方面的文化差异。了解性取向差异对损伤和症状的影响将有助于提供者努力为乳腺癌幸存者提供高质量的护理，并可能增强癌症生存。
