Abstract PS1-09-03: Let's talk about sexuality: SEXual SATisfaction questionnaire in patients with Metastatic breast cancer (SEXSAT-M)

Abstract Background: Breast cancer (BC) treatments produce changes in patients that can interfere with their identity, attractiveness, self-esteem, social relationships, and sexual functioning. Data suggest that patients with metastatic BC (MBC) report significant sexual concerns and would like support in coping with treatment-related sexual concerns. A Spanish study, developed and validated the “Sexual Satisfaction Questionnaire” (SEXSAT-Q) that is capable of measuring sexual satisfaction in early BC. It fails to cover critical aspects of MBC. For this reason, a group of Spanish hospitals has adapted and validated a new version with the objective of measuring sexual satisfaction in MBC (SEXSAT-M study). Methods: First, a focus group was conducted with 6 patients to assess concept relevance and extract contents. A sample of 22 patients was recruited at a single center to pilot the first version for language comprehension. A sample of 223 patients was recruited at 12 oncology hospitals in Spain to validate the new questionnaire. A retest sample (58 patients) was used to check time stability. Patient satisfaction is structured in four related dimensions: self-image, psychological state (depression-energy), sexual activity, and medical care. The sexual activity dimension explores content such as level of sexual activity, interest in sexual activity, discomfort, libido, and satisfaction with sexual activity. The self-administered questionnaire includes 18 items plus 3 bolt-on items from the QLQ-BR23 questionnaire referring to sexual activity in the last month. Questions are scored using a 5-point Likert scale: from 0 (No, not at all) to 4 (Yes, a lot). To assess the psychometric properties feasibility, reliability, content, construct and concurrent validity were used. Results: Focus group participants corroborated the need to assess the impact of the disease on sexual life. The pilot sample (mean age: 51.3 years, 60.9% postmenopausal) was able to answer all items with little or no effort, and 77% answered the complete questionnaire, yielding a mean response time of 7.4 minutes. One item had to be reverted for better understanding. Regarding the validation sample (mean age: 48.7 years, 34.1% postmenopausal): Of the 219 usable cases, 58% responded to all questions, while the completion rate rises to 87.7% when the 3 bolt-on questions are not considered. Question 21 (Answer this question only if you were sexually active in the last month: To what extent did you enjoy sex?) has the higher blank response rate (33.3%). A patient's score can be interpreted based on the centile in the distribution occupied by the direct score obtained. Dimension (average) scores resulted to arrange in three distinguishable levels: Libido (38.8) and Sexual Activity (42.8) located at the lowest level, Pain (51.4), Psychological State (52.5) ​​and Medical Care (57.2) at an intermediate level, and self-image (70.3) at the highest level. Self-image shows a significantly higher average than all other dimensions (p<0.001), libido and sexual activity show a significantly lower average than all other dimensions (p<0.001), psychological state, pain, and medical care do not differ from each other (p>0.05). Conclusions: The SEXSAT-M questionnaire was very well accepted and easy to complete by almost all patients, proving good face value and acceptance. Taking into account the results of this study, this new tool can help assess sexual satisfaction in the MBC population with the aim of improving sexual health at this stage of the disease. Our instrument gives the opportunity to expose a very sensitive content which MBC women have mentioned to be an important part of their lives, and which is seldom explored in regular practice. Citation Format: J. Cruz Jurado, J. Chacón López-Muñíz, S. Antolín Novoa, F. Henao Carrasco, B. Cantos Sánchez de Ibargüen, S. Estalella Mendoza, A. Santaballa Bertrán, C. Salvador-Coloma, Y. Fernández Pérez, M. Muñoz Mateu, C. Rodríguez Sánchez, M. Ruiz Díaz, B. Martín Calero, M. Ramos Aránguez, N. Gallego Pena, B. Núñez García, J. Baena-Cañada, M. Rivero Silva, C. Pagés Rivero, J. Salvador Bofill. Let's talk about sexuality: SEXual SATisfaction questionnaire in patients with Metastatic breast cancer (SEXSAT-M) [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS1-09-03.