Study: Mastectomy Doesn’t End Sexual Satisfaction

Women with breast cancer who are treated with mastectomy are just as sexually satisfied in the years after their surgery as are women treated with breast-conserving lumpectomies, according to a new research report.

The same study indicates that a more-important factor diminishing sexual satisfaction among breast-cancer survivors is the decision to take chemotherapy drugs after surgery.

Doctors often presume that lumpectomy takes less of a toll on a woman’s sexuality since it is less disfiguring than mastectomy (removal of the breast).

But study results have been mixed. And most of the surveys done until now have been either small or reliant on sexuality questionnaires not widely accepted as reliable.

Margaret Chamberlain Wilmoth, a registered nurse at the University of Kansas Medical Center in Kansas City, and Jeff Townsend, a doctoral candidate at the University of Kansas School of Education in Lawrence, asked 165 women with a history of breast cancer to fill out two well-validated questionnaires about sexual behavior and function.

The women ranged in age from 30 to 75 and most had been treated within the past five years.

The researchers found no overall differences between the two groups in terms of sexual desire, arousal or satisfaction.

Among women with mastectomies, there were also no differences between those who had followed up with reconstructive surgery and those who did not.

But in keeping with previous findings by others, the team found that women who were treated with chemotherapy drugs after surgery - whether they had a lumpectomy or a mastectomy - scored lower for sexual activity and satisfaction. Chemotherapy often shuts down women’s ovaries, causing premature menopause and other hormonal imbalances that can diminish libido and sexual sensations.

Wilmoth and Townsend conclude that doctors should not suggest to women that lumpectomy or surgical reconstruction after mastectomy will enhance sexual satisfaction, especially if surgery is to be followed by chemotherapy.

They encourage doctors to speak openly with patients about the often-ignored topic of sex after cancer, to make sure each woman makes a fully informed treatment decision. They also recommend two pamphlets about sexuality and cancer published by the American Cancer Society, one for men and the other for women. Their research appears in the September/ October issue of Cancer Practice.