Abstract

OBJECTIVES: To identify and characterize distinct trajectories of change in young women's sexual functioning over five years following breast cancer diagnosis.METHODS: Group-based trajectory modeling was applied to the sexual functioning of 896 women diagnosed with stage I-IV breast cancer at age =40 years. The Cancer Rehabilitation Evaluation System was used to evaluate women's symptoms of sexual dysfunction annually for five years.RESULTS: Five distinct trajectories of sexual functioning were identified: one asymptomatic, one minimally symptomatic, two moderately symptomatic, and one severely symptomatic trajectory. 12% of women were asymptomatic throughout follow-up. The plurality of women experienced stable mild symptoms (42%). Amongst those with moderate symptoms, some experienced improvement over time (22%) while others experienced deterioration (13%). 11% experienced stable severe symptoms that did not remit over time. Independent predictors of experiencing a symptomatic rather than asymptomatic trajectory (p<0.05, two-sided) included diagnosis with stage 2 versus 1 disease, ER+ disease treated with oophorectomy or ovarian suppression, being partnered, having anxiety, poorer body image, and greater musculoskeletal pain.CONCLUSIONS: We identified distinct trajectories that describe the reported sexual symptoms in this cohort of young breast cancer survivors. The majority of women reported various degrees of sexual dysfunction that remained stable over the study period. There is, however, potential for improvement of moderate and severe symptoms of sexual dysfunction in early survivorship.

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