Abstract P6-12-12: Improvement in sexual function over time in premenopausal women with breast cancer
Authors: Goldfarb SB , Kamer S , Baser R , Quistorff J , Gemignani ML , Dickler M 
Published: February 2018

Abstract
Background: There is evidence that many cancer survivors live with sexual dysfunction that impacts their quality of life. It is essential to identify factors that influence the development of sexual symptoms and understand their trajectory over time in order to guide potential interventions to treat sexual dysfunction. Most studies to date have been cross-sectional and longitudinal studies are needed to understand the change of sexual function over time. This study aims to investigate and describe the factors that impact sexual health and dysfunction in breast cancer patients during and after their cancer treatment.
Methods: A longitudinal prospective trial is being conducted in premenopausal women 18-50 years of age with breast cancer being treated at MSKCC. Validated questionnaires on sexual health and function were administered to patients after they were diagnosed with breast cancer, but before they initiated cancer treatment and at one-year follow-up after initiation of primary breast cancer therapy. Demographic and treatment information was also collected. The female sexual function index (FSFI) total and individual domain scores were calculated. Baseline and 12-month scores were compared using paired t-tests. Multivariable linear regression was used to assess individual variable associations with 12-month FSFI total scores controlling for baseline scores.
Results: 127 women were eligible for analysis at the time of this abstract and had a median age of 41. Eighty-nine percent of tumors were estrogen receptor positive and 24.4% were HER-2 overexpressing. Eighty-nine percent of patients received chemotherapy, 61.4% received Tamoxifen and 23% received a LHRH agonist in combination with an aromatase inhibitor. Mean FSFI total score was 20.4 at baseline and 21.2 at 12-months post diagnosis. More than half of women met FSFI criteria for sexual dysfunction (FSFI score&lt;26) at baseline (57.5%) and 12-months (55.2%). Small increases in sexual activity were seen with 27.8% of patients inactive at baseline compared to 23.2% at 12 months. Similarly, women engaging in sexual activity more than once a week increased from 9.5% to 16.8%. Desire (libido) significantly improved (p = 0.023) from baseline to 12 months. Controlling for baseline score, younger age and treatment with tamoxifen were associated with better 12-month scores (p &lt; 0.05).
Conclusions: Mean FSFI scores in our patients with breast cancer before and after treatment are consistent with scores from other studies looking at cancer patients and are lower than those of healthy women. In the peri-diagnosis period patients had worse sexual function that showed signs of small improvements 12 months after initiation of treatment, especially in the desire domain. Patients are being followed to see if sexual function continues to improve over time, to better understand the factors causing sexual dysfunction in these patients and to determine the best time to intervene in order to improve symptoms.
Citation Format: Goldfarb SB, Kamer S, Baser R, Quistorff J, Gemignani ML, Dickler M. Improvement in sexual function over time in premenopausal women with breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-12-12.