Impact of surgical modality on breast-specific sensuality

The research, "Breast-Specific Sensuality and Sexual Function in Cancer Survivorship: Does Surgical Modality Matter?," has been published in The Annals of Surgical Oncology. The research team was led by Jennifer S. Gass, MD, FACS, chief of surgery at Women & Infants Hospital, a Care New England hospital, director of the breast fellowship at the Breast Health Center at Women & Infants, and clinical assistant professor at The Warren Alpert Medical School of Brown University. The team included former Women & Infants/Brown University fellows and residents Michaela Onstad, MD, now of MD Anderson Cancer Center, Sarah Pesek, MD, now of St. Peter's Health Partners Medical Associates, Sara Fogarty, MD, now of the Greater Baltimore Medical Center, and Kristin Rojas, MD, now at Maimonides Hospital; Ashley Stuckey, MD, of Women & Infants Hospital and the Warren Alpert Medical School; Christina Raker of Women & Infants Hospital; and Don Dizon, MD, of Harvard Medical School. This work was originally presented at the Society of Surgical Oncology in Houston, TX in 2015.

According to Dr. Gass, "In an era where we see more early-staged breast cancer patients choosing mastectomy, no study has previously addressed breast specific sensuality, defined as the breast's role during intimacy. We explored breast-specific sensuality and sexual function among women who underwent lumpectomy, mastectomy alone, or mastectomy with reconstruction and analyzed the association of surgical modality with sexual function."

The study sought to explore the long-term consequences of breast surgery focusing on appearance and sexuality. The research team conducted a cross-sectional survey of women who underwent breast cancer surgery for invasive breast cancer or ductal carcinoma in situ at Women & Infants Hospital. Questions addressed such topics as satisfaction with appearance of the breast, comfort with a partner seeing the breast without clothing, and importance of the breast in intimacy and sex before and after treatment for breast cancer.

Dr. Gass explained, "We hypothesized that outside of overall sexual function, breast-specific sensuality is an important aspect of women diagnosed with breast cancer. Our results demonstrated that when asked to recall their experiences before surgery, most women viewed their breasts as integral to intimacy. We now find that in survivorship, women report that breast-specific sensuality is significantly decreased regardless of the surgical modality, but that lumpectomy has the best reported outcomes."

While women with early stage breast cancer often are cured of their disease, they live with surgical consequences throughout survivorship. These data may guide surgical counseling beyond expected overall survival to include quality of life.

"There is no doubt that overall survival is our number one priority, but ensuring a good quality of life for cancer survivors is also vital, and that includes a 'breast-inclusive' perspective of sexuality in survivorship, " said Dr. Gass.