Breast-conserving therapy linked to better sexual well-being compared to mastectomy
According to a study published in the March issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS), women with breast cancer who undergo breast-conserving therapy (BCT) report better sexual well-being than those who undergo mastectomy and breast reconstruction.
In contrast to those who underwent breast reconstruction and total mastectomy, patients who underwent BCT consistently scored higher on a measure of sexual well-being. The results emphasize how sexuality needs to be given more consideration when talking about breast cancer treatment options.
Sexual health issues are common among breast cancer patients. According to earlier research, up to 85% of patients with breast cancer report having sexual dysfunction, but few of them receive any kind of medical advice about it. BCT also referred to as lumpectomy offers many patients a successful substitute for mastectomy. Breast reconstruction has been shown to improve the quality of life and self-esteem of patients who have mastectomy.
Sexual well-being has not received much attention in research on breast cancer treatment, particularly when comparing the results of breast cancer treatment (BCT) and postmastectomy breast reconstruction (PMBR). Dr. Dot Nelson and associates examined sexual well-being scores for 15,857 patients who had breast cancer surgery between 2010 and 2022 using the validated BREAST-Q questionnaire. Approximately 46% of patients had PBMR and 54% had BCT. Using long-term follow-up when available, scores on a subscale measuring sexual well-being which includes sexual attractiveness, sexual confidence, and comfort level during intercourse were compared between groups.
Better recovery after BCT; few patients receive sexual medicine consultation
On a scale of 0 to 100, the two groups’ average scores for sexual well-being before surgery were comparable: 62 for the BCT group and 59 for the PBMR group. The BCT group’s sexual well-being score increased to 66 by six months, and it stayed there for up to five years. In comparison to BCT, women undergoing PBMR consistently scored lower on sexual well-being With longer follow-ups, the average score improved to 53 from 49 at six months. By the end of the study period, patients who had not yet undergone breast reconstruction had an even lower average sexual well-being score (41).
Overall, the BCT group’s scores were 7–6 points higher on average. Scores in other BREAST-Q domains, such as psychological well-being, breast satisfaction, and physical well-being of the chest, showed a significant correlation with sexual well-being. Sexual medicine consultation was available from a dedicated service at the authors’ cancer center, but only 3 percent of the BCT group and 5 percent of the PBMR group received it, despite the impact on sexual well-being. PBMR patients were roughly half as likely to receive a sexual medicine consultation after controlling for other variables.
The study supports earlier findings that women who undergo breast cancer BCT recover sexual well-being faster than those who undergo PMBR. The researchers write BCT may be the superior choice for patients who wish to maintain their sexual well-being among breast cancer patients who are eligible for either BCT or mastectomy.
The authors also stress how important it is to think about and talk about how breast cancer surgery affects sexual health. Dr. Dot Nelson ends by saying: Even though many patients have poor sexual health, the majority do not receive consultations for sexual medicine, indicating a chance for providers to enhance the sexual health of patients with breast cancer.