A recent study published in the March issue of Plastic and Reconstructive Surgery, the official journal of the American Society of Plastic Surgeons, reveals that women undergoing breast-conserving therapy (BCT) experience better sexual well-being compared to those who opt for mastectomy followed by breast reconstruction. The research highlights the importance of addressing sexual health when discussing treatment options with breast cancer patients. Dr. Jonas A. Nelson from Memorial Sloan Kettering Cancer Center emphasizes the need for increased attention to this aspect during consultations.

The Impact of Surgical Options on Sexual Health

Women diagnosed with breast cancer often face significant concerns regarding their sexual health. While many studies have explored various aspects of quality of life following surgery, fewer have focused on comparing BCT and postmastectomy breast reconstruction (PMBR) specifically in terms of sexual well-being. Using validated BREAST-Q questionnaires, researchers analyzed data from over 15,800 patients who underwent breast cancer surgery between 2010 and 2022. This comprehensive analysis provides valuable insights into the long-term effects of different surgical approaches.

The study found that before surgery, both groups had similar average scores for sexual well-being. However, six months post-surgery, the BCT group showed a marked improvement in their scores, reaching an average of 66 and maintaining this level up to five years later. In contrast, the PMBR group's scores were consistently lower, averaging 49 at six months and improving only slightly to 53 over time. Notably, patients who had not completed their reconstruction by the end of the study period reported even lower scores, averaging 41. These findings underscore the potential benefits of BCT in preserving sexual well-being.

Addressing Sexual Health in Breast Cancer Treatment

Despite the significant impact of breast cancer surgery on sexual health, very few patients receive specialized consultations. Only 3.5% of the BCT group and 5.4% of the PMBR group accessed sexual medicine services, highlighting a critical gap in care. Adjusted data shows that PMBR patients were about half as likely to receive such consultations. This disparity suggests an urgent need for healthcare providers to prioritize discussions about sexual health during treatment planning.

The research underscores the importance of considering sexual well-being as a key factor in decision-making for breast cancer patients. For those eligible for either BCT or mastectomy, choosing BCT may offer superior outcomes in terms of sexual well-being. Dr. Nelson concludes that although many patients experience low sexual health, most do not receive necessary support, indicating an opportunity for providers to enhance the overall care and quality of life for these patients. By integrating sexual health consultations into standard practice, healthcare professionals can better address this often-overlooked aspect of recovery.