Department of Medical, Neurological and Metabolic Sciences of Ageing, University of Campania "Luigi Vanvitelli", Naples, 80138, Italy.
Endocrine. 2018 Jun;60(3):510-515. doi: 10.1007/s12020-017-1470-7. Epub 2017 Nov 14.
Breast cancer patients (BCP) are at risk of female sexual dysfunction (FSD). Our aim was to clarify the effects of treatment strategies, and steroid hormones levels on FSD.
We enrolled 136 BCP (46.9 ± 0.8 years), and 122 completed questionnaires. BCP were divided into four groups: 22 women with advanced breast cancer on neoadjuvant therapy (NAT), 48 on adjuvant therapy (AT), 30 taking hormonal therapy (HT) and 22 with metastatic cancer on first line chemotherapy (FLT). Fifty-eight healthy women (43 ± 2.8 years) were enrolled as controls. FSD was evaluated by FSFI, and sexual distress was assessed with FSDS-R. We have collected demographic data, laboratory values, and LH, FSH, total testosterone (T), and estradiol (E2) levels.
BCP showed a prevalence of FSD of 69%, total FSFI score was 17. FSDS-R was 8.3. FSD had a prevalence of 72 % in NAT, 65% in AT, 77% in metastatic BCP under FLT, 67% in HT, compared with a prevalence of 20% in controls. BCP showed lower E2 than normal values, as well as T. LH and FSH were significantly elevated than normal values. Total FSFI score was positively correlated with T in 122 BCP, no significant correlation was found between E2 and FSFI. Significant differences were found between NAT and HT in lubrication, pain domains and total FSDS-R score, AT and HT in pain domain, AT and NAT in lubrication domain.
BCP are at high risk of developing FSD both for treatment choice and hormonal status, but they have not sexually related personal distress.
乳腺癌患者（BCP）存在女性性功能障碍（FSD）的风险。我们旨在阐明治疗策略和类固醇激素水平对 FSD 的影响。
我们纳入了 136 名 BCP（46.9±0.8 岁），其中 122 名完成了问卷调查。BCP 分为四组：22 名接受新辅助治疗（NAT）的晚期乳腺癌患者，48 名接受辅助治疗（AT）的患者，30 名接受激素治疗（HT）的患者和 22 名接受一线化疗（FLT）的转移性癌症患者。58 名健康女性（43±2.8 岁）作为对照组。采用 FSFI 评估 FSD，采用 FSDS-R 评估性困扰。我们收集了人口统计学数据、实验室值以及 LH、FSH、总睾酮（T）和雌二醇（E2）水平。
BCP 的 FSD 患病率为 69%，总 FSFI 评分为 17。FSDS-R 为 8.3。NAT、AT、FLT 下转移性 BCP 的 FSD 患病率分别为 72%、65%、77%，HT 为 67%，而对照组的患病率为 20%。BCP 的 E2 水平低于正常值，T 水平也较低。LH 和 FSH 明显高于正常值。在 122 名 BCP 中，总 FSFI 评分与 T 呈正相关，E2 与 FSFI 之间无显著相关性。在 NAT 和 HT 之间，在润滑、疼痛域和总 FSDS-R 评分方面，在 AT 和 HT 之间，在疼痛域方面，在 AT 和 NAT 之间，差异有统计学意义。
BCP 无论选择治疗方案还是激素状态，都存在发生 FSD 的高风险，但她们没有与性相关的个人困扰。
