Ferrigno Guajardo Ana, Vaca-Cartagena Bryan F, Mesa-Chavez Fernanda, Platas Alejandra, Fonseca Alan, Cruz-Ramos Marlid, Miaja Avila Melina, Rodriguez Ana Laura, Cabrera-Galeana Paula, Mohar Alejandro, Villarreal-Garza Cynthia
Department of Medicine, Yale University School of Medicine, New Haven, CT 06510, United States.
Breast Cancer Center, Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, San Pedro Garza Garcia 66260, Mexico.
JNCI Cancer Spectr. 2024 Nov 1;8(6). doi: 10.1093/jncics/pkae111.
Young women with breast cancer (YWBC) face unique challenges that can affect their sexual health. This study aimed to identify factors associated with sexual activity, function, and satisfaction in YWBC up to 5 years postdiagnosis.
We conducted a prospective cohort study of 474 women 40 years of age or younger diagnosed with nonmetastatic breast cancer in Mexico. Sexual function and satisfaction were assessed using the Female Sexual Function Index and the Sexual Satisfaction Inventory, respectively. Factors associated with sexual health outcomes were examined using mixed-effects models.
The prevalence of sexual dysfunction increased from 33.6% at baseline to 52.9% at 4-5 years postdiagnosis. Factors associated with worse sexual function included older age (mean predicted FSFI score = -1.35, P = .037), treatment-induced amenorrhea (-2.86, P < .001), depression (-4.11, P < .001), and anxiety (-2.13, P < .001). Lower sexual satisfaction was associated with lower educational attainment (mean predicted SSI score = -5.61, P = .002), being single (-6.41, P < .001), treatment-induced amenorrhea (-3.76, P = .004), bilateral oophorectomy (-8.21, P = .017), depression (-11.29, P < .001), and anxiety (-7.50, P < .001). Quality of life, body image, and systemic therapy side effects significantly affected both outcomes. Three distinct trajectories of sexual function were identified: high (62.2%), intermediate (24.3%), and markedly declining (13.5%). Four trajectories of sexual satisfaction were found, ranging from intermediate-to-high (57.3%) to progressively worsening (27.5%).
Sexual dysfunction is prevalent and persistent among YWBC. Multiple biological, psychological, and social factors influence sexual health outcomes in this population. These findings highlight the importance of routine screening and tailored interventions to address the sexual health of YWBC throughout survivorship.
患有乳腺癌的年轻女性（YWBC）面临着可能影响其性健康的独特挑战。本研究旨在确定诊断后长达5年的YWBC中性活动、性功能和性满意度的相关因素。
我们对墨西哥474名40岁及以下被诊断为非转移性乳腺癌的女性进行了一项前瞻性队列研究。分别使用女性性功能指数和性满意度量表评估性功能和性满意度。使用混合效应模型检查与性健康结果相关的因素。
性功能障碍的患病率从基线时的33.6%增加到诊断后4 - 5年时的52.9%。与性功能较差相关的因素包括年龄较大（平均预测FSFI评分为 -1.35，P = 0.037）、治疗引起的闭经（-2.86，P < 0.001）、抑郁（-4.11，P < 0.001）和焦虑（-2.13，P < 0.001）。较低的性满意度与较低的教育程度（平均预测SSI评分为 -5.61，P = 0.002）、单身（-6.41，P < 0.001）、治疗引起的闭经（-3.76，P = 0.004）、双侧卵巢切除术（-8.21，P = 0.017）、抑郁（-11.29，P < 0.001）和焦虑（-7.50，P < 0.001）相关。生活质量、身体形象和全身治疗副作用对这两个结果均有显著影响。确定了三种不同的性功能轨迹：高（62.2%）、中（24.3%）和明显下降（13.5%）。发现了四种性满意度轨迹，从中等至高（57.3%）到逐渐恶化（27.5%）。
YWBC中性功能障碍普遍存在且持续存在。多种生物学、心理和社会因素影响该人群的性健康结果。这些发现凸显了在YWBC整个生存期进行常规筛查和针对性干预以解决其性健康问题的重要性。
