title: Changes in sexual problems over time in women with and without early-stage breast cancer.
abstract: OBJECTIVE
  We aimed to evaluate whether age-matched women with and without early-stage breast cancer differentially experience sexual problems over time and whether changes in patients' problems differ by type of surgical procedure.
  
  
  METHODS
  We conducted four interviews (4-6 wk, 6 mo, and 1 and 2 y) after tumor resection (patients) or after a negative/benign screening mammogram (controls). Mixed-effects models with repeated ordinal measurements tested the effects of time and diagnostic group (stages 0, I, and IIA vs controls) and, for patients, the effects of time and type of surgical procedure (mastectomy vs lumpectomy) using a newly developed nine-item sexual-problem measure. Two-sided P values < 0.05 were considered significant.
  
  
  RESULTS
  Using data from 1,033 women (17.3% stage 0, 33.4% stage I/IIA, and 49.3% controls; mean age, 57.1 y; 23.1% nonwhite; 64.7% married), two factors measuring problems with sexual attractiveness and sexual interest/enjoyment emerged in exploratory factor analysis (alpha > or = 0.74 for each subscale and the nine-item measure). Patients and controls reported few sexual problems on average, but controls were more likely to report sexual problems on the nine-item measure over time and stage I patients were less likely to report problems with sexual attractiveness over time (each P < 0.05) compared with at baseline. Patients who underwent mastectomy (35.7%) were 2.7 times more likely to report sexual problems on the nine-item measure at 2-year follow-up compared with baseline (P = 0.0339).
  
  
  CONCLUSIONS
  Patients and controls experienced few sexual problems over time, and in fact, controls were more likely to report sexual problems at subsequent interviews, whereas patients were not.
authors.affiliation: Division of Health Behavior Research, Department of Internal Medicine, Washington University School of Medicine, St Louis, MO 63108, USA. mperez@dom.wustl.edu
authors.forename: Maria
authors.initials: M
authors.lastname: Pérez
authors.forename: Ying
authors.initials: Y
authors.lastname: Liu
authors.forename: Mario
authors.initials: M
authors.lastname: Schootman
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Aft
authors.forename: Kenneth B
authors.initials: KB
authors.lastname: Schechtman
authors.forename: William E
authors.initials: WE
authors.lastname: Gillanders
authors.forename: Donna B
authors.initials: DB
authors.lastname: Jeffe
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology* / Q000523:psychology* / Q000601:surgery; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007407:Interviews as Topic; D008327:Mammography / Q000523:psychology; D008408:Mastectomy / Q000523:psychology; D008875:Middle Aged; D009367:Neoplasm Staging; D011788:Quality of Life; D020018:Sexual Dysfunctions, Psychological / Q000453:epidemiology*; D017741:Survivors
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