title: Sexuality after breast reconstruction post mastectomy.
abstract: BACKGROUND
  Sexual dysfunction is a medical condition that can lead to relationship issues as well as depression and has a somatoform basis. It is estimated to affect 49 % of Brazilian women. Studies have shown that both cancer diagnosis and its surgical treatment (mastectomy) affect women psychologically and can lead to psychiatric disorders. The aim of this study was to evaluate and compare sexuality in women who underwent mastectomy alone with those who underwent breast reconstruction after mastectomy.
  
  
  METHODS
  This descriptive transversal study analyzed two groups of patients, one with 17 women after mastectomy alone and another with 19 women who underwent breast reconstruction post mastectomy. The patients ranged in age from 18 to 60 years old. The exclusion criteria were illiteracy; ongoing chemotherapy, radiotherapy, or psychiatric treatment; or if any surgery had been performed the previous year. All patients were from the Gynecology and Plastic Surgery Department of the Federal University of São Paulo. They voluntarily answered the FSFI (Female Sexual Function Index) questionnaire. Statistical analyses were performed using Student's t test and Pearson's coefficient, and the significance level used was p < 0.05.
  
  
  RESULTS
  Data showed a lower FSFI score for the mastectomy-alone group compared to the breast reconstruction group (median = 10.15 ± 2.636 and 22.44 ± 3.055, respectively; p = 0.0057). There was no relationship established between the scores and postoperative time (post, p = 0.9382; pre, p = 0.2142) or between scores and remuneration income (post, p = 0.7699; pre, p = 0.5245), stable relationship (post, p = 0.2613; pre, p = 0.5245), and age (post, p = 0.3951; pre, p = 0.8427) for both groups. Mean age has shown no significant difference (p = 0.4740; median post = 47.71 ± 2.012; medina pre = 46.69 ± 1.809).
  
  
  CONCLUSIONS
  An improvement in sexual function has been observed in patients who underwent breast reconstruction after mastectomy, probably as a result of better self-esteem as well as body image, both of which are affected by a mastectomy. The aesthetic results were evaluated using a questionnaire, and all the patients answered positively.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
authors.affiliation: Division of Plastic Surgery, Surgery Department, Escola Paulista de Medicina-Universidade Federal de São Paulo, São Paulo, Brazil. mviniciusmed@yahoo.com.br
authors.forename: Miguel Sabino
authors.initials: MS
authors.lastname: Neto
authors.forename: Marcel Vinicius
authors.initials: MV
authors.lastname: de Aguiar Menezes
authors.forename: João Ricardo
authors.initials: JR
authors.lastname: Moreira
authors.forename: Elvio Bueno
authors.initials: EB
authors.lastname: Garcia
authors.forename: Luiz Eduardo Felipe
authors.initials: LE
authors.lastname: Abla
authors.forename: Lydia Masako
authors.initials: LM
authors.lastname: Ferreira
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000523:psychology / Q000601:surgery; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000523:psychology; D008408:Mastectomy / Q000523:psychology; D008875:Middle Aged; D011184:Postoperative Period; D012725:Sexual Behavior; D019529:Sexuality