Garg Surabhi, Mishra Anand Kumar, Singh Kul Ranjan, Enny Loreno, Ramakant Pooja
Department of Endocrine Surgery, Shatabdi Hospital, King George's Medical University, Phase IIUttar Pradesh, Shamina Road, Lucknow, India.
Indian J Surg Oncol. 2024 Sep;15(3):601-608. doi: 10.1007/s13193-024-01957-3. Epub 2024 May 18.
Sexual health is often a neglected issue and affects the quality of life after treatment completion in breast cancer patients. The aim of the study was to find the incidence of sexual dysfunction and impact of mastectomy, breast conservation surgery (BCS), and hormone therapy in eligible patients on female sexuality in breast cancer survivors. It is a prospective study of 150 non-metastatic pre-menopausal BC survivors. Each participant answered the Female Sexual Function Index (FSFI) questionnaire at 4 weeks and at 3 months after completion of all therapy. Scores were compared between mastectomy and BCS patients and on hormonal therapy versus non-hormonal therapy. Chemotherapy was given to all patients and > 90% received adjuvant radiotherapy. Patients underwent both mastectomy ( = 104; 70%) and BCS ( = 46), based on imaging, staging, and patients' choice. Of the patients, 82.6% ( = 124) had sexual dysfunction at 3 months post-treatment (cutoff of 26.55). BCS survivors had significantly better scores in comparison to mastectomy survivors at 3-month interval evaluation (median 22.85 ± 2.19 versus 21.75 ± 2.09, = 0.002). There was statistically non-significant reduction in arousal, lubrication, orgasm, pain in mastectomy survivors, and in desire, arousal, and pain in hormonal group survivors, at 3 months follow-up. Overall sexual dysfunction is high in breast cancer survivors irrespective of therapy (82.6%); however, it is more in patients undergoing mastectomy in comparison to patients undergoing conservative surgery in short-term follow-up. Sexual dysfunction issues needs to be addressed during survivorship programs, and longer follow-up is necessary to assess effect of various treatment modalities.
性健康往往是一个被忽视的问题,并且会影响乳腺癌患者治疗结束后的生活质量。本研究的目的是在符合条件的患者中,找出性功能障碍的发生率以及乳房切除术、保乳手术(BCS)和激素疗法对乳腺癌幸存者女性性功能的影响。这是一项针对150名非转移性绝经前乳腺癌幸存者的前瞻性研究。每位参与者在所有治疗结束后的4周和3个月时回答女性性功能指数(FSFI)问卷。对乳房切除术和保乳手术患者之间以及激素治疗与非激素治疗之间的得分进行了比较。所有患者均接受了化疗,超过90%的患者接受了辅助放疗。根据影像学、分期和患者选择,患者分别接受了乳房切除术(n = 104;70%)和保乳手术(n = 46)。在治疗后3个月时,82.6%(n = 124)的患者存在性功能障碍(临界值为26.55)。在3个月的间隔评估中,保乳手术幸存者的得分显著高于乳房切除术幸存者(中位数分别为22.85±2.19和21.75±2.09,P = 0.002)。在3个月的随访中,乳房切除术幸存者的性唤起、润滑、性高潮、疼痛方面以及激素治疗组幸存者的性欲、性唤起和疼痛方面,在统计学上均无显著降低。无论采用何种治疗方法,乳腺癌幸存者的总体性功能障碍发生率都很高(82.6%);然而,在短期随访中,与接受保守手术的患者相比,接受乳房切除术的患者性功能障碍更为严重。在康复计划中需要解决性功能障碍问题,并且需要更长时间的随访来评估各种治疗方式的效果。