Sexuality and quality of life in women with a prior diagnosis of breast cancer after risk-reducing salpingo-oophorectomy.
OBJECTIVE
To investigate the prevalence of sexual dysfunction in women with a history of breast cancer following risk-reducing salpingo-oophorectomy (RRSO). A secondary objective was to examine the effect of a prior diagnosis of breast cancer, and other factors, on sexuality and quality of life (QoL) outcomes.


METHODS
Cross-sectional study of 119 women who underwent RRSO between 2009 and 2014.


METHODS
Data were collected via a questionnaire comprising demographic information and validated measures of sexual function, sexual distress, relationship satisfaction, body image, psychological stress, menopause symptoms and general quality of life.


RESULTS
Sixty out of 119 participants who underwent RRSO had a history of breast cancer. Eighty percent of women with breast cancer had female sexual dysfunction (FSD) and 82% had hypoactive sexual desire disorder (HSDD) after RRSO. Bilateral mastectomy was associated with higher rates of HSDD (p = 0.028) and higher body image self-consciousness (BISC) during sexual activity (p = 0.011). Breast reconstruction was associated with higher relationship satisfaction (RAS) scores (p = 0.004). Compared to Tamoxifen, aromatase inhibitors (AI) were significantly associated with reduced lubrication (p = 0.041), arousal (p = 0.004), orgasm (p = 0.002) and greater dyspareunia (p = 0.027). Prior diagnosis of breast cancer was not associated with the prevalence of FSD (p = 0.532).


CONCLUSIONS
High rates of FSD and HSDD occur in women with breast cancer following RRSO. Low relationship satisfaction, bodily pain, bilateral mastectomy and the use of aromatase inhibitors were associated with poorer sexual function. Women had similar sexual outcomes and QoL after RRSO, regardless of breast cancer history.
St John of God Hospital Bendat Family Comprehensive Cancer Centre, 12 Salvado Rd, Subiaco, WA 6008, Australia; School of Medicine, University of Notre Dame, 19 Mouat St, Fremantle, WA 6160, Australia. Electronic address: Paige.Tucker@sjog.org.au.
Paige E
PE
Tucker
St John of God Hospital Bendat Family Comprehensive Cancer Centre, 12 Salvado Rd, Subiaco, WA 6008, Australia; School of Surgery, University of Western Australia, 35 Stirling Hwy, Crawley, WA 6009, Australia. Electronic address: christobel.saunders@uwa.edu.au.
Christobel
C
Saunders
Institute for Health Research, University of Notre Dame, 19 Mouat St, Fremantle, WA 6160, Australia. Electronic address: Max.Bulsara@nd.edu.au.
Max K
MK
Bulsara
St John of God Hospital Bendat Family Comprehensive Cancer Centre, 12 Salvado Rd, Subiaco, WA 6008, Australia; School of Medicine, University of Notre Dame, 19 Mouat St, Fremantle, WA 6160, Australia. Electronic address: Jason@womencentre.com.au.
Jason Jit-Sun
JJ
Tan
St John of God Hospital Bendat Family Comprehensive Cancer Centre, 12 Salvado Rd, Subiaco, WA 6008, Australia; School of Medicine, University of Notre Dame, 19 Mouat St, Fremantle, WA 6160, Australia. Electronic address: Stuart.Salfinger@health.wa.gov.au.
Stuart G
SG
Salfinger
Women Centre, 2 McCourt St, West Leederville, WA 6007, Australia. Electronic address: Helena@relate-sexology.com.au.
Helena
H
Green
St John of God Hospital Bendat Family Comprehensive Cancer Centre, 12 Salvado Rd, Subiaco, WA 6008, Australia; Institute for Health Research, University of Notre Dame, 19 Mouat St, Fremantle, WA 6160, Australia. Electronic address: Paul.Cohen@sjog.org.au.
Paul A
PA
Cohen
D000328:Adult; D000368:Aged; D047072:Aromatase Inhibitors / Q000627:therapeutic use; D001828:Body Image / Q000523:psychology; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D003430:Cross-Sectional Studies; D004414:Dyspareunia / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D016462:Mammaplasty; D008408:Mastectomy; D008593:Menopause; D008875:Middle Aged; D010052:Ovariectomy; D010549:Personal Satisfaction; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D040242:Risk Reduction Behavior; D058994:Salpingectomy; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology* / Q000523:psychology; D020018:Sexual Dysfunctions, Psychological / Q000453:epidemiology* / Q000523:psychology; D019529:Sexuality; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D014904:Western Australia / Q000453:epidemiology
D047072:Aromatase Inhibitors
Aromatase inhibitor; BRCA1/2; Mastectomy; Risk-reducing salpingo-oophorectomy; Sexuality; Tamoxifen