Abstract P4-01-10: Sexual well-being and its association with breast surgery indications: an exploratory study

Abstract Purpose: Although breast surgery can have a negative impact on a woman’s body image, we are not aware of studies measuring the impact of surgery for benign breast disease on sexuality or body image. There are studies on the impact of breast surgery on sexuality and body image for breast cancer (BC) survivors. We want to know if breast surgery has an impact on sexual wellbeing after breast surgery and/or if other BC specific treatments weigh on the decline in sexual functioning after breast surgery. Therefore, we compared sexual functioning in patients who underwent breast surgery for invasive BC versus patient who underwent breast surgery for a benign, prophylactic or premalignant indication. Methods: Between October 2021 and January 2024, we recruited female patients older than 18 years with a history of breast surgery (self-report) via: 1) consultation site of the breast clinic of the University Hospitals Leuven; 2) social media platforms of Think Pink vzw (https://www.think-pink.be/nl); and 3) patients support groups. After giving eConsent, participants completed an online survey, which included validated questionnaires: Female Sexual Function Index (FSFI), Female Sexual Distress Scale (FSDS-R), World Health Organization – Five Well-being Index (WHO-5), and Dyadic Adjustment Scale (DAS). Results: We recruited 86 participants who underwent surgery for invasive BC (n=74; mean age: 50,1y; age range: 25-69y) and non-invasive indication (n=12; mean age: 45,5y; age range: 21-72y). Both groups had a comparable outcome for DAS (BC – group mean score: 117,9 versus non-BC group mean score: 119,9) indicating a good partner relation in both groups and WHO-5 (BC-group: 51,17 versus non BC-group: 61,45) indicating a good well-being in both groups (using the cutoff score of 50). Combing the cutoff score of the FSFI (i.e., <25) and the FSDS-R (i.e., >11), we found that in the BC-group 41/74 (55,4%) had a sexual dysfunction compared to 2/12 (16,7%) in the non BC-group. When considering the use of endocrine therapy, we noticed that a sexual disfunction was present in 52,4% of BC survivors who never took endocrine therapy, in 55,9% of those still taking endocrine therapy and in 60,0% of those who stopped endocrine therapy. We found poorer sexual function after breast surgery in the invasive BC group (mean total FSFI score: 18.83) compared to the non-BC group (mean total FSFI score: 23,47). While participants with invasive BC who never took endocrine therapy (n=21) had a mean FSFI-score of 21,4, those still taking endocrine therapy (n=43) had a mean FSFI-score of 17,67 and those who stopped endocrine therapy (n=10) had a mean FSFI-score of 15,51. We found more sexual distress after breast surgery in the invasive BC group (mean FSDS-R score: 24,0) compared to the non-BC group (mean FSDS-R = 10,9). While participants with invasive BC who never took endocrine therapy (n=21) had a mean FSDR-R-score of 18,14, those still taking endocrine therapy (n=43) had a mean FSDS-R-score of 24,65 and those who stopped endocrine therapy had a mean FSDS-R score of 34,89. Conclusions: This study shows that a higher percentage of women who underwent breast surgery due to a malignancy (52.4%) reported a sexual dysfunction compared to the non-BC group (16,7%). Moreover, women using endocrine therapy reported lower sexual function and higher sexual distress compared to women who never used endocrine therapy. Women who stopped endocrine therapy reported the lowest scores on sexual function and the highest scores on sexual distress. These results highlight the importance of addressing sexual side effects during BC treatment and follow-up. Citation Format: Nynke Willers, Paul Enzlin, Patrick Neven, Sileny. N. Han. Sexual well-being and its association with breast surgery indications: an exploratory study [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P4-01-10.