Effects of surgical and adjuvant therapies for breast cancer on sexuality, cognitive functions, and body weight.
BACKGROUND
Breast cancer and its treatment negatively affect the important aspects of a woman's life such as sexual health, cognitive functions, body image, and weight. Abrupt estrogen deficiency following chemotherapy and/or hormonal therapy plays an important role in worsening of sexuality.


OBJECTIVE
To evaluate the impact of breast cancer treatment on sexual functioning, cognitive function, and body weight in premenopausal women.


METHODS
Thirty-five women with a premenopausal diagnosis of breast cancer who are candidate to adjuvant treatment completed validated questionnaires on menopausal symptoms, sexuality, partner relationship, depression, body image, and cognitive functions after surgery (T0), then after chemotherapy or at least 6 months of endocrine therapy (T1), and after 1 year (T2). In addition, gynecological and dietological examinations were performed.


METHODS
The following validated questionnaires were used: Greene Climacteric Scale, Beck Depression Inventory, Body Attitude Test, McCoy revised Italian version McCoy Female Sexuality Questionnaire, Cues for Sexual Desire Scale, Dyadic Adjustment Scale, Numeric Matrix Test and Rey auditory-verbal learning test, to measure cognitive functions, a recall 24 H questionnaire to evaluate food intake, Minnesota Leisure Time Physical Activity questionnaire and Eating Attitude Test-40, while anthropometric and plicometry data were assessed by a dietitian.


RESULTS
Low levels of sexual functioning were registered at baseline; a further decrease in sexual activity, quality of the partnered relationship, desire, and arousability was demonstrated at T1 and T2. We found a significant increase in hot flushes and anxiety. Nonsignificant deterioration of body image was demonstrated. Although women reported losing memory and concentration, "chemobrain" effect was not demonstrated as cognitive tests improved after 6 months, probably because of "learning effect." Women who had undergone chemotherapy gained weight and fat disposition was typically android.


CONCLUSIONS
Young women undergoing adjuvant breast cancer therapy experience a heavy impairment in important quality of life domains as sexuality and targeted support interventions are needed.
Department of Gynaecological Oncology, University of Turin, Mauriziano Umberto I Hospital and Institute for Cancer Research and Treatment of Candiolo (IRCC), Turin, Italy. nbiglia@mauriziano.it
Nicoletta
N
Biglia
Giulia
G
Moggio
Elisa
E
Peano
Paola
P
Sgandurra
Riccardo
R
Ponzone
Rossella E
RE
Nappi
Piero
P
Sismondi
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use / Q000633:toxicity*; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology; D050218:Body Fat Distribution; D001828:Body Image; D001835:Body Weight / Q000187:drug effects*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000523:psychology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D003071:Cognition / Q000187:drug effects*; D003131:Combined Modality Therapy / Q000009:adverse effects / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives*; D006801:Humans; D008594:Menopause, Premature / Q000523:psychology; D009043:Motor Activity / Q000187:drug effects; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology; D019529:Sexuality / Q000187:drug effects*
D007987:Gonadotropin-Releasing Hormone