Sexuality after breast cancer treatment: An experience of asymmetry.

BACKGROUND

Breast cancer survivorship is often associated with a negative impact on sexual function and sexual well-being. Given that sexual well-being contributes to quality of life-including for breast cancer survivors-it is important to address survivors' sexual worries during the treatment process.

OBJECTIVE

This study explored factors that contribute to changes in sexual functioning and sexual well-being after breast cancer diagnosis and treatment in otherwise healthy patients.

DESIGN

Narrative qualitative study using thematic analysis.

METHOD

We included 25 breast cancer survivors without severe comorbidities for individual interviews ( = 16) and 2 focus group discussions ( = 4 and  = 6). One participant attended both an individual interview and a focus group discussion.

RESULTS

After the diagnosis of breast cancer, a sudden shift emerged in relation to life before and after breast cancer. A thematic analysis resulted in the identification of one high-level theme: asymmetry. This asymmetry was experienced in the following domains: (1) physical asymmetry in the chest region after surgery and radiotherapy, (2) sexual asymmetry; differences in how the body and mind react to sexual stimuli due to residual physical side effects and the effects of ongoing treatment: a lack of sexual desire, severe vaginal dryness and/or dyspareunia, and lack of vaginal arousal response during sexual activity, (3) life asymmetry in time- and self-management, which deprives patients from experiences that make someone feel good about oneself, (4) asymmetry in the experience in invulnerability: the reality of the sexual side effects of treatment and expectations of these side effects after being informed by a healthcare professional, and (5) relational asymmetry: asymmetry between the partners in their relationship due to role confusion and role changes.

CONCLUSION

Breast cancer diagnosis and treatment have a distinct impact on sexual function and sexual well-being. Changes in social relationships due to the diagnosis and the physical side effects of treatment are associated with a decline in sexual well-being, which should receive more attention in research and clinical care.