Division of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Psychooncology. 2019 May;28(5):1033-1040. doi: 10.1002/pon.5047. Epub 2019 Mar 13.
To identify and characterize distinct trajectories of change in young women's sexual functioning over the first 5 years following breast cancer diagnosis.
Group-based trajectory modeling was applied to the sexual functioning of 896 women diagnosed with stage I-IV breast cancer at age 40 or younger. The Cancer Rehabilitation Evaluation System was used to evaluate women's symptoms of sexual dysfunction annually for 5 years.
Five distinct trajectories of sexual functioning were identified: one asymptomatic, one minimally symptomatic, two moderately symptomatic, and one severely symptomatic trajectory. Twelve percent of women were asymptomatic throughout follow-up. The plurality of women experienced stable mild symptoms (42%). Among those with moderate symptoms, some experienced improvement over time (22%) while others experienced deterioration (13%); 11% experienced stable severe symptoms that did not remit over time. Independent predictors of experiencing a symptomatic rather than asymptomatic trajectory (P < 0.05, two-sided) included diagnosis with stage 2 versus 1 disease, ER positive disease treated with oophorectomy or ovarian suppression, being partnered, having anxiety, poorer body image, and greater musculoskeletal pain.
We identified distinct trajectories that describe the reported sexual symptoms in this cohort of young breast cancer survivors. The majority of women reported various degrees of sexual dysfunction that remained stable over the study period. There is, however, potential for improvement of moderate and severe symptoms of sexual dysfunction in early survivorship.
确定并描述年轻女性乳腺癌诊断后 5 年内性功能变化的不同轨迹。
采用基于群组的轨迹建模方法，对 896 名年龄在 40 岁及以下被诊断为 I-IV 期乳腺癌的女性的性功能进行分析。使用癌症康复评估系统（Cancer Rehabilitation Evaluation System）每年评估女性 5 年的性功能障碍症状。
确定了五种不同的性功能轨迹：一种无症状，一种轻度症状，两种中度症状，一种重度症状。12%的女性在整个随访期间无症状。大多数女性经历稳定的轻度症状（42%）。在中度症状的患者中，有些患者随着时间的推移症状有所改善（22%），而有些患者则有所恶化（13%）；11%的患者经历稳定的严重症状，且随时间无缓解。经历有症状而非无症状轨迹的独立预测因素（P<0.05，双侧）包括 2 期而非 1 期疾病诊断、ER 阳性疾病接受卵巢切除术或卵巢抑制治疗、有伴侣、有焦虑、较差的身体形象和更大的肌肉骨骼疼痛。
我们确定了描述该年轻乳腺癌幸存者队列中报告的性症状的不同轨迹。大多数女性报告了不同程度的性功能障碍，这些障碍在研究期间保持稳定。然而，在早期生存者中，中度和重度性功能障碍的症状有改善的潜力。
