Skórzewska Magdalena, Kurylcio Andrzej, Rawicz-Pruszyński Karol, Chumpia Wachirabhorn, Punnanan Buabongkoj, Jirapongvanich Sasiwan, Jiang Tianxiao, Mielko Jerzy
Department of Surgical Oncology, Medical University of Lublin, Radziwiłłowska 13 St., 20-080 Lublin, Poland.
J Clin Med. 2021 Feb 3;10(4):567. doi: 10.3390/jcm10040567.
Although mastectomy could lead to a decrease in sexual performance among patients, only a handful of studies focused on the psychological and sexual behavioral aspects after the surgery. Research on post-mastectomy sexuality has focused mainly on female subjects but barely on lesbian, gay, bisexual, transgender, queer (LGBTQ), and male patients. This narrative review aimed to explore the importance of sexuality after mastectomy from a LGBTQ perspective. Each sexual minority group has been addressed individually. In general, sexual and gender minority breast cancer (BC) patients undergoing bilateral mastectomy expect a complex treatment plan in terms of physical and emotional outcomes. Bilateral mastectomy or top surgery for masculinization reasons was reported to be the most popular procedure among transmen, which resulted in a significant improvement in the quality of life. Heterosexual and lesbian female patients are willing to undergo mastectomy after repeated lumpectomies or to avoid radiation, despite potential post-operative somatic and quality-of-life complications. Transwomen would seek gender-affirming surgery to improve physical satisfaction and psychological well-being. There is not enough evidence for non-oncological reasons and consequences of mastectomy in gay men and cisgender heterosexual men. Establishing the awareness of the sexuality impact of mastectomy will allow the implementation of tailored perioperative psychological care.
尽管乳房切除术可能会导致患者性功能下降，但仅有少数研究关注术后的心理和性行为方面。乳房切除术后性行为的研究主要集中在女性受试者，而几乎没有涉及女同性恋、男同性恋、双性恋、跨性别者、酷儿（LGBTQ）以及男性患者。本叙述性综述旨在从LGBTQ视角探讨乳房切除术后性方面的重要性。每个性少数群体都已单独论述。总体而言，接受双侧乳房切除术的性和性别少数乳腺癌（BC）患者在身体和情感结果方面期望有一个复杂的治疗方案。据报道，出于男性化原因进行的双侧乳房切除术或胸部手术是跨性别男性中最受欢迎的手术，这导致生活质量有显著改善。异性恋和女同性恋女性患者尽管术后可能存在躯体和生活质量方面的并发症，但仍愿意在多次肿块切除术后接受乳房切除术或避免放疗。跨性别女性会寻求性别确认手术以提高身体满意度和心理健康水平。对于男同性恋和顺性别异性恋男性进行乳房切除术的非肿瘤学原因及后果，目前尚无足够证据。确立对乳房切除术性影响的认识将有助于实施针对性的围手术期心理护理。
