Research progress on sexual life quality of breast cancer patients and their spouses_West China Medical Journal

Authors：

ZENG Xiaohong ¹ , TAO Lin ¹ , CHEN Huaying ¹ , CHEN Jinglin ¹ ,  LI Junying ²

1. Cancer Day-Care Unit, Cancer Center, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Division of Thoracic Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

LI Junying, Email: hxoncoljy@126.com

Keywords：

Breast cancer; sexual life quality; spouse; couple; review

DOI：

10.7507/1002-0179.202412091

Video：

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Breast cancer patients and their spouses face a series of problems in their sexual life, which together lead to the decline of the sexual life quality of the couple, endangering the physical and mental health and the marital relationship of the patients and their spouses. Therefore, this article reviews the current situation, assessment tools, and influencing factors of sexual life quality of breast cancer patients and their spouses, and introduces the foreign intervention measures of sexual life quality based on the dual perspective of husband and wife, in order to promote the development of research on sexual life of breast cancer patients and their spouses in China, and provide references for the construction of a localized intervention program to improve the sexual life quality.

1.	Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2024, 74(3): 229-263.
2.	Bottomley A, Reijneveld JC, Koller M, et al. Current state of quality of life and patient-reported outcomes research. Eur J Cancer, 2019, 121: 55-63.
3.	Pa?ari? S, Orkic Z, Srb AM, et al. Quality of life and sexual functioning of women after breast cancer surgery. Open Access Maced J Med Sci, 2021, 9(B): 1066-1074.
4.	周志豪, 梁培禾, 陳衍霖, 等. 乳腺癌對患者配偶性功能的影響. 中華男科學雜志, 2022, 28(1): 26-31.
5.	Kowalczyk R, Nowosielski K, Cedrych I, et al. Factors affecting sexual function and body image of early-stage breast cancer survivors in poland: a short-term observation. Clin Breast Cancer, 2019, 19(1): e30-e39.
6.	Momeni ES, Danesh M, Moosazadeh M, et al. Sexual quality of life of breast cancer survivors: a cross-sectional study. Asian Pac J Cancer Prev, 2023, 24(5): 1621-1627.
7.	Suo R, Ye F, Xie M, et al. Quality of sexual life and associated factors: a cross-sectional survey of Chinese breast cancer patients. Support Care Cancer, 2023, 31(2): 120.
8.	Yan R, Yu J, Tanimoto T, et al. The relationship between sexual activity and sexual attitudes among breast cancer survivors in China. Cancer Med, 2020, 9(10): 3425-3436.
9.	Smedsland SK, Vandraas KF, B?hn SK, et al. Sexual activity and functioning in long-term breast cancer survivors; exploring associated factors in a nationwide survey. Breast Cancer Res Treat, 2022, 193(1): 139-149.
10.	Tian Z, Xiaolu Z, Jing Y, et al. A longitudinal study of sexual activity and influencing factors in breast cancer patients during treatment in the Southwest of China: a trajectory analysis model. BMC Womens Health, 2024, 24(1): 352.
11.	Bagherinia M, Dolatian M, Mahmoodi Z, et al. Predictors of social intermediate factors associated with sexual quality of life of women: systematic review and meta-analysis. BMC Womens Health, 2024, 24(1): 64.
12.	陳澤剛, 王永兵, 周泉, 等. 乳腺癌術后患者性功能和性活動狀況及影響因素. 慢性病學雜志, 2023, 24(3): 369-374.
13.	Bobrie A, Jarlier M, Moussion A, et al. Sexual quality of life assessment in young women with breast cancer during adjuvant endocrine therapy and patient-reported supportive measures. Support Care Cancer, 2022, 30(4): 3633-3641.
14.	von Hippel C, Rosenberg SM, Austin SB, et al. Identifying distinct trajectories of change in young breast cancer survivors’ sexual functioning. Psychooncology, 2019, 28(5): 1033-1040.
15.	Wahid MNA, Muhamad R, Mohamad N, et al. “Sexual sacrifice”: a qualitative exploration of husbands’ experience of living with survivors of breast cancer-sexual dysfunction in Malaysia. Support Care Cancer, 2024, 32(8): 531.
16.	Maleki M, Mardani A, Ghafourifard M, et al. Changes and challenges in sexual life experienced by the husbands of women with breast cancer: a qualitative study. BMC Womens Health, 2022, 22(1): 326.
17.	Yeung NCY, Zhang Y, Ji L, et al. Correlates of sexual quality of life among husbands of Chinese breast cancer survivors. Eur J Oncol Nurs, 2019, 40: 63-70.
18.	Almont T, Delannes M, Ducassou A, et al. Sexual quality of life and needs for sexology care of cancer patients admitted for radiotherapy: a 3-month cross-sectional study in a regional comprehensive reference cancer center. J Sex Med, 2017, 14(4): 566-576.
19.	Cohee A, Storey S, Winger JG, et al. A cohort study of quality of life in partners of young breast cancer survivors compared to partners of healthy controls. J Patient Rep Outcomes, 2020, 4(1): 19.
20.	Blouet A, Zinger M, Capitain O, et al. Sexual quality of life evaluation after treatment among women with breast cancer under 35 years old. Support Care Cancer, 2019, 27(3): 879-885.
21.	許月娥, 李娟. 集束化護理對乳腺癌改良根治術后患者性生活質量的影響. 國際護理學雜志, 2020, 39(11): 2077-2080.
22.	張超, 郎潔, 郭凡, 等. 女性乳腺癌患者乳房切除術后性教育對負性情緒及性生活質量的影響. 中國醫學前沿雜志(電子版), 2022, 14(3): 44-47.
23.	Symonds T, Boolell M, Quirk F. Development of a questionnaire on sexual quality of life in women. J Sex Marital Ther, 2005, 31(5): 385-397.
24.	Telli S, Gürkan A. Examination of sexual quality of life and dyadic adjustment among women with mastectomy. Eur J Breast Health, 2019, 16(1): 48-54.
25.	胡蕾, 胡佩誠. 女性性生活質量問卷的編制和信效度檢驗. 中國心理衛生雜志, 2008, 22(6): 447-450.
26.	胡蕾, 胡佩誠, 唐茂芹, 等. 女性性生活質量問卷在精神分裂癥患者中的信度和效度. 精神醫學雜志, 2010, 23(4): 241-243.
27.	景麗偉. 乳腺癌生存者性生活質量現狀分析及質量評價工具研制. 沈陽: 中國醫科大學, 2018: 153-154.
28.	吳候瓊. 性行為指導對中青年男性直腸癌造口患者性生活質量的干預作用研究. 中國性科學, 2020, 29(6): 9-12.
29.	Arolfo S, Scozzari G, Di Benedetto G, et al. Surgically induced weight loss effects on sexual quality of life of obese men: a prospective evaluation. Surg Endosc, 2020, 34(12): 5558-5565.
30.	Abraham L, Symonds T, Morris MF. Psychometric validation of a sexual quality of life questionnaire for use in men with premature ejaculation or erectile dysfunction. J Sex Med, 2008, 5(3): 595-601.
31.	Woodward JM, Hass SL, Woodward PJ. Reliability and validity of the Sexual Life Quality Questionnaire (SLQQ). Qual Life Res, 2002, 11(4): 365-377.
32.	Zhang Y, Sun S, Ding J, et al. The effect of different surgical methods on female and male sexual activity and marital quality in patients with early-stage cervical cancer. Sex Med, 2020, 8(2): 307-314.
33.	Acosta-Santillán PL, Toro-Sashida MF, Rosas-Mendoza AV, et al. Quality of sexual life in Mexican men after spinal cord injury. J Rehabil Med, 2023, 55: jrm11641.
34.	Najimi A, Veisani Y, Azami S, et al. Investigating the sexual quality of life and its relationship with general health in older men in Iran. J Educ Health Promot, 2020, 9: 150.
35.	?zayd?n AN, Do?an E, Bozdo?an B. Men’s knowledge and attitudes towards breast cancer: a descriptive study. Eur J Breast Health, 2020, 16(3): 183-191.
36.	Vegunta S, Kuhle CL, Vencill JA, et al. Sexual health after a breast cancer diagnosis: addressing a forgotten aspect of survivorship. J Clin Med, 2022, 11(22): 6723.
37.	Chew PY, Choy CL, Sidi HB, et al. The association between female sexual dysfunction and sexual dysfunction in the male partner: a systematic review and meta-analysis. J Sex Med, 2021, 18(1): 99-112.
38.	Yan R, Wang J, Yu J. Association of sexual attitudes with sexual dysfunction and sexual distress among Chinese breast cancer survivors: a cross-sectional study. Support Care Cancer, 2023, 31(3): 154.
39.	Brajkovic L, Sladic P, Kopila? V. Sexual quality of life in women with breast cancer. Health Psychol Res, 2021, 9(1): 24512.
40.	Catania AM, Sammut Scerri C, Catania GJ. Men’s experience of their partners’ breast cancer diagnosis, breast surgery and oncological treatment. J Clin Nurs, 2019, 28(9/10): 1899-1910.
41.	張麗, 張曉娜, 陳長香, 等. 丈夫態度及社會支持對乳腺癌患者性功能障礙的影響. 現代預防醫學, 2017, 44(23): 4318-4321, 4331.
42.	Stulz A, Favez N, Flahault C. Emotional and sexual adaptation to colon cancer: perceptual congruence of dyadic coping among couples. Front Psychol, 2022, 13: 802603.
43.	Rottmann N, Larsen PV, Johansen C, et al. Sexual activity in couples dealing with breast cancer. a cohort study of associations with patient, partner and relationship-related factors. Front Psychol, 2022, 13: 828422.
44.	Faghani S, Ghaffari F. Effects of sexual rehabilitation using the PLISSIT model on quality of sexual life and sexual functioning in post-mastectomy breast cancer survivors. Asian Pac J Cancer Prev, 2016, 17(11): 4845-4851.
45.	Barjasteh S, Lopez V, Farnam F. Group sex counseling based on a modified “good enough sex” model: a randomized trial on sexual health variables among breast cancer survivors in Iran. J Sex Marital Ther, 2024, 50(6): 741-756.
46.	Jonsdottir JI, Vilhjalmsson R, Svavarsdottir EK. Effectiveness of a couple-based intervention on sexuality and intimacy among women in active cancer treatment: a quasi-experimental study. Eur J Oncol Nurs, 2021, 52: 101975.
47.	Hummel SB, van Lankveld JJDM, Oldenburg HSA, et al. Efficacy of internet-based cognitive behavioral therapy in improving sexual functioning of breast cancer survivors: results of a randomized controlled trial. J Clin Oncol, 2017, 35(12): 1328-1340.
48.	Hummel SB, van Lankveld JJDM, Oldenburg HSA, et al. Sexual functioning and relationship satisfaction of partners of breast cancer survivors who receive internet-based sex therapy. J Sex Marital Ther, 2019, 45(2): 91-102.
49.	Reese JB, Smith KC, Handorf E, et al. A randomized pilot trial of a couple-based intervention addressing sexual concerns for breast cancer survivors. J Psychosoc Oncol, 2019, 37(2): 242-263.
50.	Cullen K, Fergus K. Acceptability of an online relational intimacy and sexual enhancement (iRISE) intervention after breast cancer. J Marital Fam Ther, 2021, 47(2): 515-532.

1. Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2024, 74(3): 229-263.
2. Bottomley A, Reijneveld JC, Koller M, et al. Current state of quality of life and patient-reported outcomes research. Eur J Cancer, 2019, 121: 55-63.
3. Pa?ari? S, Orkic Z, Srb AM, et al. Quality of life and sexual functioning of women after breast cancer surgery. Open Access Maced J Med Sci, 2021, 9(B): 1066-1074.
4. 周志豪, 梁培禾, 陳衍霖, 等. 乳腺癌對患者配偶性功能的影響. 中華男科學雜志, 2022, 28(1): 26-31.
5. Kowalczyk R, Nowosielski K, Cedrych I, et al. Factors affecting sexual function and body image of early-stage breast cancer survivors in poland: a short-term observation. Clin Breast Cancer, 2019, 19(1): e30-e39.
6. Momeni ES, Danesh M, Moosazadeh M, et al. Sexual quality of life of breast cancer survivors: a cross-sectional study. Asian Pac J Cancer Prev, 2023, 24(5): 1621-1627.
7. Suo R, Ye F, Xie M, et al. Quality of sexual life and associated factors: a cross-sectional survey of Chinese breast cancer patients. Support Care Cancer, 2023, 31(2): 120.
8. Yan R, Yu J, Tanimoto T, et al. The relationship between sexual activity and sexual attitudes among breast cancer survivors in China. Cancer Med, 2020, 9(10): 3425-3436.
9. Smedsland SK, Vandraas KF, B?hn SK, et al. Sexual activity and functioning in long-term breast cancer survivors; exploring associated factors in a nationwide survey. Breast Cancer Res Treat, 2022, 193(1): 139-149.
10. Tian Z, Xiaolu Z, Jing Y, et al. A longitudinal study of sexual activity and influencing factors in breast cancer patients during treatment in the Southwest of China: a trajectory analysis model. BMC Womens Health, 2024, 24(1): 352.
11. Bagherinia M, Dolatian M, Mahmoodi Z, et al. Predictors of social intermediate factors associated with sexual quality of life of women: systematic review and meta-analysis. BMC Womens Health, 2024, 24(1): 64.
12. 陳澤剛, 王永兵, 周泉, 等. 乳腺癌術后患者性功能和性活動狀況及影響因素. 慢性病學雜志, 2023, 24(3): 369-374.
13. Bobrie A, Jarlier M, Moussion A, et al. Sexual quality of life assessment in young women with breast cancer during adjuvant endocrine therapy and patient-reported supportive measures. Support Care Cancer, 2022, 30(4): 3633-3641.
14. von Hippel C, Rosenberg SM, Austin SB, et al. Identifying distinct trajectories of change in young breast cancer survivors’ sexual functioning. Psychooncology, 2019, 28(5): 1033-1040.
15. Wahid MNA, Muhamad R, Mohamad N, et al. “Sexual sacrifice”: a qualitative exploration of husbands’ experience of living with survivors of breast cancer-sexual dysfunction in Malaysia. Support Care Cancer, 2024, 32(8): 531.
16. Maleki M, Mardani A, Ghafourifard M, et al. Changes and challenges in sexual life experienced by the husbands of women with breast cancer: a qualitative study. BMC Womens Health, 2022, 22(1): 326.
17. Yeung NCY, Zhang Y, Ji L, et al. Correlates of sexual quality of life among husbands of Chinese breast cancer survivors. Eur J Oncol Nurs, 2019, 40: 63-70.
18. Almont T, Delannes M, Ducassou A, et al. Sexual quality of life and needs for sexology care of cancer patients admitted for radiotherapy: a 3-month cross-sectional study in a regional comprehensive reference cancer center. J Sex Med, 2017, 14(4): 566-576.
19. Cohee A, Storey S, Winger JG, et al. A cohort study of quality of life in partners of young breast cancer survivors compared to partners of healthy controls. J Patient Rep Outcomes, 2020, 4(1): 19.
20. Blouet A, Zinger M, Capitain O, et al. Sexual quality of life evaluation after treatment among women with breast cancer under 35 years old. Support Care Cancer, 2019, 27(3): 879-885.
21. 許月娥, 李娟. 集束化護理對乳腺癌改良根治術后患者性生活質量的影響. 國際護理學雜志, 2020, 39(11): 2077-2080.
22. 張超, 郎潔, 郭凡, 等. 女性乳腺癌患者乳房切除術后性教育對負性情緒及性生活質量的影響. 中國醫學前沿雜志(電子版), 2022, 14(3): 44-47.
23. Symonds T, Boolell M, Quirk F. Development of a questionnaire on sexual quality of life in women. J Sex Marital Ther, 2005, 31(5): 385-397.
24. Telli S, Gürkan A. Examination of sexual quality of life and dyadic adjustment among women with mastectomy. Eur J Breast Health, 2019, 16(1): 48-54.
25. 胡蕾, 胡佩誠. 女性性生活質量問卷的編制和信效度檢驗. 中國心理衛生雜志, 2008, 22(6): 447-450.
26. 胡蕾, 胡佩誠, 唐茂芹, 等. 女性性生活質量問卷在精神分裂癥患者中的信度和效度. 精神醫學雜志, 2010, 23(4): 241-243.
27. 景麗偉. 乳腺癌生存者性生活質量現狀分析及質量評價工具研制. 沈陽: 中國醫科大學, 2018: 153-154.
28. 吳候瓊. 性行為指導對中青年男性直腸癌造口患者性生活質量的干預作用研究. 中國性科學, 2020, 29(6): 9-12.
29. Arolfo S, Scozzari G, Di Benedetto G, et al. Surgically induced weight loss effects on sexual quality of life of obese men: a prospective evaluation. Surg Endosc, 2020, 34(12): 5558-5565.
30. Abraham L, Symonds T, Morris MF. Psychometric validation of a sexual quality of life questionnaire for use in men with premature ejaculation or erectile dysfunction. J Sex Med, 2008, 5(3): 595-601.
31. Woodward JM, Hass SL, Woodward PJ. Reliability and validity of the Sexual Life Quality Questionnaire (SLQQ). Qual Life Res, 2002, 11(4): 365-377.
32. Zhang Y, Sun S, Ding J, et al. The effect of different surgical methods on female and male sexual activity and marital quality in patients with early-stage cervical cancer. Sex Med, 2020, 8(2): 307-314.
33. Acosta-Santillán PL, Toro-Sashida MF, Rosas-Mendoza AV, et al. Quality of sexual life in Mexican men after spinal cord injury. J Rehabil Med, 2023, 55: jrm11641.
34. Najimi A, Veisani Y, Azami S, et al. Investigating the sexual quality of life and its relationship with general health in older men in Iran. J Educ Health Promot, 2020, 9: 150.
35. ?zayd?n AN, Do?an E, Bozdo?an B. Men’s knowledge and attitudes towards breast cancer: a descriptive study. Eur J Breast Health, 2020, 16(3): 183-191.
36. Vegunta S, Kuhle CL, Vencill JA, et al. Sexual health after a breast cancer diagnosis: addressing a forgotten aspect of survivorship. J Clin Med, 2022, 11(22): 6723.
37. Chew PY, Choy CL, Sidi HB, et al. The association between female sexual dysfunction and sexual dysfunction in the male partner: a systematic review and meta-analysis. J Sex Med, 2021, 18(1): 99-112.
38. Yan R, Wang J, Yu J. Association of sexual attitudes with sexual dysfunction and sexual distress among Chinese breast cancer survivors: a cross-sectional study. Support Care Cancer, 2023, 31(3): 154.
39. Brajkovic L, Sladic P, Kopila? V. Sexual quality of life in women with breast cancer. Health Psychol Res, 2021, 9(1): 24512.
40. Catania AM, Sammut Scerri C, Catania GJ. Men’s experience of their partners’ breast cancer diagnosis, breast surgery and oncological treatment. J Clin Nurs, 2019, 28(9/10): 1899-1910.
41. 張麗, 張曉娜, 陳長香, 等. 丈夫態度及社會支持對乳腺癌患者性功能障礙的影響. 現代預防醫學, 2017, 44(23): 4318-4321, 4331.
42. Stulz A, Favez N, Flahault C. Emotional and sexual adaptation to colon cancer: perceptual congruence of dyadic coping among couples. Front Psychol, 2022, 13: 802603.
43. Rottmann N, Larsen PV, Johansen C, et al. Sexual activity in couples dealing with breast cancer. a cohort study of associations with patient, partner and relationship-related factors. Front Psychol, 2022, 13: 828422.
44. Faghani S, Ghaffari F. Effects of sexual rehabilitation using the PLISSIT model on quality of sexual life and sexual functioning in post-mastectomy breast cancer survivors. Asian Pac J Cancer Prev, 2016, 17(11): 4845-4851.
45. Barjasteh S, Lopez V, Farnam F. Group sex counseling based on a modified “good enough sex” model: a randomized trial on sexual health variables among breast cancer survivors in Iran. J Sex Marital Ther, 2024, 50(6): 741-756.
46. Jonsdottir JI, Vilhjalmsson R, Svavarsdottir EK. Effectiveness of a couple-based intervention on sexuality and intimacy among women in active cancer treatment: a quasi-experimental study. Eur J Oncol Nurs, 2021, 52: 101975.
47. Hummel SB, van Lankveld JJDM, Oldenburg HSA, et al. Efficacy of internet-based cognitive behavioral therapy in improving sexual functioning of breast cancer survivors: results of a randomized controlled trial. J Clin Oncol, 2017, 35(12): 1328-1340.
48. Hummel SB, van Lankveld JJDM, Oldenburg HSA, et al. Sexual functioning and relationship satisfaction of partners of breast cancer survivors who receive internet-based sex therapy. J Sex Marital Ther, 2019, 45(2): 91-102.
49. Reese JB, Smith KC, Handorf E, et al. A randomized pilot trial of a couple-based intervention addressing sexual concerns for breast cancer survivors. J Psychosoc Oncol, 2019, 37(2): 242-263.
50. Cullen K, Fergus K. Acceptability of an online relational intimacy and sexual enhancement (iRISE) intervention after breast cancer. J Marital Fam Ther, 2021, 47(2): 515-532.

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