RT Book, Section
A1 Ruddy, Kathryn J.
A1 Partridge, Ann H.
A2 Kuerer, Henry M.
SR Print(0)
ID 6406622
T1 Chapter 101. Fertility, Sexuality, and Menopausal Symptom Management
T2 Kuerer's Breast Surgical Oncology
YR 2010
FD 2010
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-160178-8
LK accesssurgery.mhmedical.com/content.aspx?aid=6406622
RD 2024/04/19
AB Improvements  in  the  detection  and  treatment  of  breast  cancer  have  resulted  in  a  growing  number  of  breast  cancer  survivors.  It  has  been  estimated  that  there  are  now  more  than  2  million  breast  cancer  survivors  in  the  United  States  alone,  and  many  more  worldwide.1  As  these  women  go  on  to  live  healthy  and  productive  lives,  many  will  experience  burdensome  menopausal  symptoms,  such  as  hot  flashes  and  vaginal  dryness,  and  impairments  in  sexual  functioning.  Couzi  et  al2  reported  that,  of  women  previously  diagnosed  with  early-stage  breast  cancer,  65%  suffered  hot  flashes,  44%  night  sweats,  48%  vaginal  dryness,  26%  dyspareunia,  44%  difficulty  sleeping,  and  44%  feeling  depressed.  Physical  and  emotional  problems  arising  from  the  diagnosis  and  treatment  of  breast  cancer  may  compound  each  other,  creating  a  complex  interplay  of  symptoms.  Sexual  problems  may  result  from  a  combination  of  the  psychosocial  trauma  associated  with  the  diagnosis  of  breast  cancer,  changes  in  body  image,  and  treatment  side  effects.  Atrophic  vaginitis,  a  constellation  of  symptoms  including  vaginal  dryness  and  associated  urogenital  inflammation,  atrophy,  stenosis,  pruritus,  and  dyspareunia,  is  particularly  problematic  for  sexual  functioning.3  Without  treatment,  these  symptoms  can  be  lasting  and  severe.  Speer  et  al4  found  that  breast  cancer  survivors  an  average  of  4.4  years  after  treatment  had  reduced  sexual  functioning  in  all  domains  except  desire  when  compared  with  previously  published  data  on  women  without  a  history  of  cancer.  In  a  direct  comparison  with  age-matched  control  women,  Broeckels  et  al3  found  that  women  who  had  been  treated  for  breast  cancer  at  least  5  years  previously  reported  worse  sexual  functioning  including  greater  lack  of  sexual  interest,  inability  to  relax  and  enjoy  sex,  difficulty  becoming  aroused,  and  difficulty  achieving  an  orgasm.