Clinical factors are not the best predictors of quality of sexual life and sexual functioning in women with early stage breast cancer.
BACKGROUND
Few studies have prospectively assessed the impact of breast cancer (BC) on women's sexual lives. Therefore, this study examines the determinants of quality of sexual life (QOSL), sexual functioning (SF), and sexual enjoyment (SE) at 6 and 12 months after surgical treatment.


METHODS
All participants completed a measure of QOSL (The World Health Organization Quality of Life assessment instrument-100 (WHOQOL-100)-facet Sexual Activity) before diagnosis (Time-1), and 1 (Time-2), 3 (Time-3), 6 (Time-4) and 12 months (Time-5) after surgical treatment. At Time-1, women also completed questionnaires on personality (The State Trait Anxiety Inventory-trait, NEO-FFI), body image and self-esteem (WHOQOL-100), depressive symptoms (Center for Epidemiological Studies-Depression Scale), and fatigue (Fatigue Assessment Scale). Furthermore, SF and SE (The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Breast Cancer module) were measured from Time-2 onwards.


RESULTS
At baseline, the analysis included 223 women with early stage BC. Clinical factors did not predict QOSL, SF or SE. In the final analyses, trait anxiety predicted QOSL and SF at Time-4 (p's<0.01). At Time-5, agreeableness predicted QOSL and SE (p's<0.05). Having a partner and age predicted SF, while SE was predicted by educational level (Time-4). In addition, fatigue predicted SE at Time-4 (p<0.05). In general, QOSL diminished across time, while SF improved. However, women with a mastectomy did not differ from women with breast conserving therapy.


CONCLUSIONS
Mainly personality and psychological factors affect patients' sexuality after surgical treatment. Clinical factors did not predict QOSL, SF or SE. More knowledge in this field will help professionals to identify women who are at risk of experiencing sexual problems and consequently will contribute to provide adequate support.
Den Oudsten
Brenda L
BL
CoRPS-Center of Research on Psychology in Somatic Diseases, Department of Medical Psychology, Tilburg University, Tilburg, The Netherlands. b.l.denoudsten@uvt.nl
Van Heck
Guus L
GL
Van der Steeg
Alida F W
AF
Roukema
Jan A
JA
De Vries
Jolanda
J
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology / Q000523:psychology; D001828:Body Image; D001943:Breast Neoplasms / Q000523:psychology*; D003863:Depression / Q000209:etiology / Q000523:psychology; D004522:Educational Status; D005221:Fatigue / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D010551:Personality; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012649:Self Concept; D012725:Sexual Behavior / Q000523:psychology*; D011795:Surveys and Questionnaires; D013997:Time Factors