Introduction: Although a number of studies have examined sexual difficulties among breast cancer survivors, few have focused on multiple dimensions of sexual functioning or partners' attitudes and difficulties. This pilot study sought a more comprehensive examination of sexual functioning among couples after breast cancer.

Methods: Patients who were at least 6 months post-treatment and were involved in committed relationships were recruited during routine clinic visits. Those who accepted to participate in the study were handed by the investigator a stamped self-addressed envelope (to the research office of the Cancer Institute) containing two questionnaires, for the patient and for her partner, and a cancer information sheet. No identifiable information was collected. Thus, the IRB did not require a written consent form.

Results: 200 patients were invited to participate in the study. 120 were in a stable relationship but only 100 accepted to take the envelope. The rest of the patients were single (76) or separated after their diagnosis (4; 2%). 38 couples participated by returning their completed questionnaires; they had been partnered for an average of 34.9 (14.3) years. Mean time since diagnosis was 40.4 (22.4) months, and mean age was 58.1 (11.5). 71.05% were currently receiving hormonal therapy.

Among the patients, 63.2% reported that they were sexually active and, retrospectively, reported that their sexual relationship had been satisfying prior to diagnosis. Currently, however, a large subgroup of patients (30.4%) reported markedly limited sexual satisfaction (“a little bit” or “not at all”). Additionally, 30.4%-to-43.5% reported low sexual interest; 69.6% reported significant problems with lubrication; 52.2% reported limited orgasm; and 30.4%-to- 60.9% had difficulties with vaginal discomfort.

Among partners, 67.6% reported that they were sexually active. Their sexual relationships prior to diagnosis were recalled as having been highly satisfying. Currently, none of the sexually active partners reported low satisfaction, though a few (8.3%) had not been active in the past month. Few partners reported low sexual interest (0% - 4.2%). Marked erectile difficulties were reported by 16.7% to 20.8%, and 25.0% reported difficulties with orgasm.

The top 3 factors that patients endorsed as interfering with their current sexual functioning (“quite a bit” or “very much”) were (1) pain (41.7%), (2) fatigue (37.5%), and (3) feeling unattractive (20.8%). Fewer participants endorsed concerns about breast tenderness (16.7%), hot flashes (12.5%), surgical scars (12.5%), their partners' reactions (16.7%), and their partners' own sexual difficulties (12.5%). For partners, the factors most commonly viewed as disrupting the sexual relationship were the patient's vaginal dryness (32.0%), the patient's fatigue (28.0%), and the partner's own sexual problems (20.0%).

Conclusion: Our results suggest that a large proportion of breast cancer survivors experience difficulties in multiple dimensions of sexual functioning. Contrary to a popular belief, separation rate after the diagnosis of breast cancer was low (2%) and most patients and their partners identified vaginal dryness and fatigue (not the breast surgery) as the major factors interfering with their sexual functioning.

Citation Format: Makhoul I, Pennisi A, Ochoa D, Klimberg S, Henry-Tillman R, Mack K, Hutchins L, Sherman AAC. Sexual functioning among breast cancer survivors and their partners: A pilot study [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-11-19.