Sexual functioning and depression among Egyptian breast cancer patients following surgery and neoadjuvant/adjuvant chemotherapy

Abstract

Background: Breast cancer and its treatment may have a negative impact of the sexual wellbeing of patients and psychological morbidity may further add to this impact. Little is known about the sexuality of Egyptian patients with breast cancer. This may be due to barriers related to health care professionals, patients and their families and the culture. Aim(s): To evaluate sexual functioning among Egyptian breast cancer patients following treatment and to determine the relation between their sexual wellbeing and anxiety and depression and other possible factors. Method(s): This prospective cross-sectional observational study included married breast cancer patient from20 to 50 years of age who underwent surgery and received neoadjuvant/ adjuvant chemotherapy. The Female Sexual Function Index (FSFI) was used to assess their sexual wellbeing. FSFI total score cutoff value of 26.55 was used to determine sexual dysfunction. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression. In addition, demographic and clinical data were collected. Result(s): Thirty-six out of 38 patients (94.7%) invited to participate in the study signed an informed consent and completed the FSFI questionnaire. The mean FSFI total score was 23.1+/-7.4 and 61% of patients had sexual dysfunction. The HADS depression scale was>7 (borderline-abnormal/abnormal) in 12 (33%) patients and the HADS anxiety scale was>7 in 25 (69%). Patients with borderline-abnormal/abnormal HADS depression score had a significantly lower FSFI total score compared to those with normal HADS depression score (20 vs. 25, respectively; p=0.029). The HADS anxiety score did not correlate significantly with the FSFI scores. Conclusion(s): Unlike the common belief, the majority of Egyptian female breast cancer patients included in this study was willing to discuss their sexual wellbeing. The results suggest that a significant proportion of Egyptian patients who completed treatment for breast cancer experience sexual dysfunction and psychological morbidity and that sexual dysfunction correlate significantly with depression among them.