Over the last decades, living conditions of breast cancer (BC) survivors have received special attention particularly in young BC survivors who specially face difficulties related to fertility and sexuality.
Non-metastatic BC women diagnosed from 2009 to 2016, aged <= 40 years at diagnosis were identified through the FRANCIM Network. Participants completed self-report questionnaires including standardized measures (sexuality, Health Related Quality of Life (HRQoL), anxiety, depression, deprivation, social support and alcohol consumption); and fertility issues. Sexuality profiles were identified by ascending hierarchical classification.
In total, 561 BC survivors from 14 French cancers Registries participated in the survey (response rate of 29%). The mean age at diagnosis was 35.9 (SD=3.8). Main tumors characteristics were AJCC stage 2-3 (61%), Hormone Receptor positive (76%), HER2 positive (24%), and Tumor grade >2 (91%). Most patients underwent lumpectomy (72%), chemotherapy (60%), radiotherapy (85%), endocrine therapy (71%) and few patients underwent targeted therapies (23%). More than 5 years after diagnosis, 48% reported sexual dysfunction. About 47% of women received information about the impact of BC treatment on fertility, and 34% reported that they received information about fertility preservation. Among 18% of women who had pregnancy project at diagnosis, 35% became pregnant after treatment. Ascending hierarchical clustering allowed to identify 3 distinct sexuality profiles from worse sexual function to the best respectively in 20%, 30% and 50%. Deprivation and treatment with endocrine therapy (especially tamoxifen) were associated with an increased risk of sexual dysfunction. The highest average score of HRQoL was in the physical functioning scale (82.2) and the lowest was in vitality (48.2).
This study showed that more than five year after diagnosis, BC survivors experienced difficulties related to sexuality. Specific interventions in this population should focus on in the management of sexual dysfunction and the improvement of the HRQoL.
Centre Georges-François Leclerc.
This work was supported by the Fonds de Dotation PFIZER INNOVATION FRANCE and the European Regional Development Fund (FEDER).
All authors have declared no conflicts of interest.