Background: Despite the high prevalence of sexual problems (50—90%) among women with early stage breast cancer (EBC), relatively little is known about the prevalence of clinically significant post-systemic treatment sexual dysfunction (SD) and its impact on quality of life (QOL). According to the American Psychiatric Association (APA), SD consists of sexual problems causing marked personal distress. While 40% of healthy US women report sexual problems, only 12% experience SD. No study has applied the APA criterion to document the prevalence of SD in women with EBC who have completed systemic therapy. The goal of this study is to address this gap and to examine some correlates (anxious predispositions and menopausal symptoms) of SD and the impact of SD on QOL. Methods: Post-menopausal women receiving cancer therapy for EBC or early colon cancer were approached for this study. Sexual problems were evaluated with the Female Sexual Function Index while sexual distress was assessed with the Female Sexual Distress Scale. QOL was measured with FACT-B, using its endocrine symptoms subscale (ES) to assess menopausal symptoms. Spielberger State-Trait Anxiety Inventory measured anxious predispositions. Participants completed questionnaires upon completion of adjuvant chemotherapy but prior to initiation of hormonal therapy (estrogen sensitive EBC). SD was assessed using the APA classification. Results: Between January 2009 and May 1 2010, 70 EBC patients entered this study. The proportion of women (mean age 61) reporting 1 or more sexual problems was high (93%) and included problems with 1) frequency (66%) and level (65%) of sexual desire, 2) frequency (66%), level (52%) and satisfaction (43%) of arousal, 3) frequency (21%) of vaginal dryness and difficulty becoming lubricated (47%) during sexual activity, 4) satisfaction with their sexual life (30%) and 5) pain during intercourse (18%). However, the APA criterion identified only 30% of patients as having SD. Multiple logistic regression showed that anxiety predispositions and menopausal symptoms predicted SD (p< .01). Women classified as having SD had higher anxiety scores (No SD=34 SD=41, p<.05) as well as higher levels of menopausal symptoms (i.e, lower ES scores; No SD= 62 SD=54, p<.01). QOL was negatively impacted by SD (r=-0.42, p<.01). Discussion: Despite the fact that an overwhelming majority of patients had sexual difficulties, the APA distress criterion identified far fewer patients (30 %) with SD. Nevertheless, we found a high prevalence rate of SD, which was 2.5 times higher (%2 < .01) than that reported in women without a cancer diagnosis. Women with anxious predispositions and high menopausal symptoms may be at risk for SD and may benefit from early interventions to prevent SD.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-12-02.