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Sexual Well-Being Among Partnered Women With Breast Cancer Recurrence

Barbara L. Andersen, Kristen M. Carpenter, Hae-Chung Yang, Charles L. Shapiro

From the Departments of Psychology and Internal Medicine, Division of Hematology/Oncology, College of Medicine, and the Comprehensive Cancer Center, Ohio State University, Columbus, OH

Address reprint requests to Barbara L. Andersen, PhD, 149 Psychology Building, 1835 Neil Ave, Columbus, OH 43210; e-mail: Andersen.1{at}osu.edu

Purpose A woman's risk for sexual disruption after breast cancer recurrence has received little clinical or research attention.

Patients and Methods Breast cancer patients recently diagnosed with recurrence (n = 60) were initially assessed at baseline and completed follow-ups at 4, 8, and 12 months. They were compared by age, stage, and duration and frequency of follow-up with matched patients who remained disease free (n = 120). Using linear mixed modeling, the groups were compared in their trajectories of change on measures of sexuality, relationship satisfaction, cancer-specific stress, and physical functioning. Recurrence subgroups, those with locoregional versus distant disease and those younger versus older than 52 years, were also compared.

Results At baseline, the recurrence group had significantly lower intercourse frequency and physical functioning compared with the disease-free group and these differences were maintained. There were no significant differences in the frequencies of kissing or sexual and relationship satisfactions. For the recurrence group patients, the heightened stress of the diagnostic/early recurrence treatment period declined to the lower disease-free levels by 12 months. This effect was largely due to improvement of the patients with distant disease. Finally, sexual changes were most notable for younger patients.

Conclusion To our knowledge, this is the first longitudinal, controlled study of sexuality—sexuality in the context of other quality of life domains—for women coping with recurrence. Despite disruption, patients maintained their sexual lives. Younger and distant recurrence patients, however, may have greatest risk of sexual disruption. The factors contributing to sexual disruption remain unknown, and studies investigating strategies to help patients maintain this aspect of quality of life are needed.

Supported in part by the American Cancer Society Grants No. PBR-89 and RSGPB-03-248-01-PBP; Longaberger Company-American Cancer Society Grant No. PBR-89A for Breast Cancer Research; the Walther Cancer Institute; the U.S. Army Medical Research Acquisition Activity Grants No. DAMD17-94-J-4165, DAMD17-96-1-6294, and DAMD17-97-1-7062; National Institutes of Mental Health Grant No. 1 RO1 MH51487; the National Cancer Institute Grants No. KO5 CA098133 and RO1 CA92704; the General Clinical Research Center Grant No. MO1-RR0034; and the Ohio State University Comprehensive Cancer Center Grant No. P30 CA16058.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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