Breast cancer surgery: Comparing surgical groups and determining individual differences in postoperative sexuality and body change stress.

Abstract

Women diagnosed and surgically treated for regional breast cancer (N = 190) were studied to determine the sexual and body change sequelae for women receiving modified radical mastectomy (MRM) with breast reconstruction in comparison with the sequelae for women receiving breast-conserving therapy (BCT) or MRM without breast reconstruction. The sexuality pattern for women receiving reconstructive surgery was one that was significantly different--with lower rates of activity and fewer signs of sexual responsiveness--than that for women in either of the other groups. Significantly higher levels of traumatic stress and situational distress regarding the breast changes were reported by the women receiving an MRM in contrast to the women treated with BCT. Using a model to predict sexual morbidity, regression analyses revealed that individual differences in sexual self-schema were related to both sexual and body change stress outcomes.

Sexual Self Schema as a Moderator of Sexual and Psychological Outcomes for Gynecologic Cancer Survivors

“…Descriptive statistics for the sample, collapsed across disease sites, are provided in Table 1. The mean SSS score (sexual self schema) was 59.1, a score similar to that found for other samples, including breast cancer patients (M = 59; Yurek, Farrar & Andersen, 2000), gynecologic cancer patients (M = 57; Andersen et al, 1997;M = 56.1;Scott, Halford, & Ward, 2004), healthy adult women (M = 59; Andersen et al, 1997), and multiple samples of undergraduate women (M = 60.5; Andersen & Cyranowski, 1994 and M = 59.5;Cyranowski & Andersen, 2000).…”

Body image and sexual problems in young women with breast cancer

“…During the first six months after treatment Ganz et al (2004) found that sexual functioning was worse for women who received chemotherapy than for those who did not, regardless of type of surgery. Yurek et al (2000) found sexual activity after treatment was predicted by the extent of treatment and menopausal status, as well as by prior frequency of intercourse and sexual self-schema. Menopausal status was important to the woman's subsequent sexual desire and sexual arousal, while extent of treatment was related to her ability to experience orgasm and total sexual responsiveness (Yurek et al, 2000).…”

“…The relationship of good body image with the resumption of sexual relations and sexual dysfunction is inconsistent. While the majority of studies have found this relationship (Carver et al, 1998;Beckmann et al, 1983;Steinberg et al, 1985;Pozo et al, 1992;Ganz et al, 2004;Yurek et al, 2000;Lee et al, 1992;Wolberg et al, 1989;Schain et al, 1994) a few have not (Ashcroft et al, 1985;Penman et al, 1986;Ganz et al, 1987;Goldberg et al, 1992).…”

“…Some studies found that women with a mastectomy were more likely to report body image dissatisfaction than those with breast conserving treatment (Beckmann et al, 1983;Steinberg et al, 1985;Ganz et al, 1992;Yurek et al, 2000;Lee et al, 1992;Schain et al, 1994;Taylor et al, 2002;Arora et al, 2001;Polivy, 1977;Avis et al, 2004), while other studies did not find type of surgery to be a significant problem (Wolberg et al, 1989;Ashcroft et al, 1985;Penman et al, 1986;Goldberg et al, 1992;Holmberg et al, 1989). Length of time since treatment can be a factor in how women feel about their appearance.…”

“…Sexual functioning declined during the first year after breast cancer treatment with chemotherapy in three studies (Ganz et al, 2004;Yurek et al, 2000;Arora et al, 2001). During the first six months after treatment Ganz et al (2004) found that sexual functioning was worse for women who received chemotherapy than for those who did not, regardless of type of surgery.…”