Sexual functioning in long-term breast cancer survivors treated with adjuvant chemotherapy

Background. Previous reports suggest that problems in sexual functioning may be common among long-term (>5 years) breast cancer survivors. To investigate this issue further, we examined the characteristics and correlates of sexual functioning in women diagnosed with breast cancer at least 5 years previously and treated with adjuvant chemotherapy and in an age-matched comparison group of women with no history of cancer. Patients and methods. Participants were 58 women initially diagnosed with breast cancer at an average of 7.65 years previously and 61 women with no history of cancer. All participants completed standardized self-report measures of sexual functioning, marital functioning, depression, fatigue, and menopausal symptoms. Results. Compared with women with no history of cancer, long-term breast cancer survivors reported worse sexual functioning (P less than or equal to 0.01), characterized by greater lack of sexual interest, inability to relax and enjoy sex, difficulty becoming aroused, and difficulty achieving an orgasm. Additional analyses indicated that severity of vaginal dryness was significantly (P less than or equal to 0.05) related to poorer sexual functioning among long-term breast cancer survivors and mediated the relationship between group membership (breast cancer survivor v.s. noncancer comparison subject) and sexual functioning. Conclusions. These findings confirm and extend previous reports of impaired sexual functioning among long-term breast cancer survivors. Results further suggest that relief of vaginal dryness should be an essential component of efforts to improve sexual functioning among long-term breast cancer survivors.