Sexual dysfunctions in breast cancer patients: evidence in context

Riccardo Vizza; Elisabetta Maria Capomolla; Livia Tosetto; Giacomo Corrado; Valentina Bruno; Benito Chiofalo; Francesca Sofia Di Lisa; Lorena Filomeno; Laura Pizzuti; Eriseld Krasniqi; Giuseppe Sanguineti; Alice Villa; Andrea Giannini; Ramy Kayal; Vincenzo Stranges; Silverio Tomao; Claudio Botti; Federica Tomao; Maddalena Barba; Enrico Vizza; Gennaro Ciliberto; Patrizia Vici

doi:10.1093/sxmrev/qead006

Sexual dysfunctions in breast cancer patients: evidence in context

Sex Med Rev. 2023 Jun 27;11(3):179-195. doi: 10.1093/sxmrev/qead006.

Authors

Riccardo Vizza¹, Elisabetta Maria Capomolla², Livia Tosetto², Giacomo Corrado³, Valentina Bruno⁴, Benito Chiofalo⁴, Francesca Sofia Di Lisa⁵, Lorena Filomeno⁵, Laura Pizzuti², Eriseld Krasniqi², Giuseppe Sanguineti⁶, Alice Villa⁷, Andrea Giannini⁸, Ramy Kayal⁹, Vincenzo Stranges¹, Silverio Tomao¹⁰, Claudio Botti¹¹, Federica Tomao¹², Maddalena Barba², Enrico Vizza⁴, Gennaro Ciliberto¹³, Patrizia Vici⁵

Affiliations

¹ "Sapienza" University of Rome, Rome 00161, Italy.
² Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome 00144, Italy.
³ Department of Woman and Child Health and Public Health, Woman Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome 00168, Italy.
⁴ Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Rome 00144, Italy.
⁵ Phase IV Clinical Studies Unit, IRCCS Regina Elena National Cancer Institute, Rome 00144, Italy.
⁶ Department of Radiation Oncology, IRCCS Regina Elena National Cancer Institute, Rome 00144, Italy.
⁷ Department of Experimental Medicine, "Sapienza" University of Rome, Rome 00161, Italy.
⁸ Department of Medical and Surgical Sciences and Translational Medicine, Sant'Andrea University Hospital, "Sapienza" University of Rome, Rome 00189, Italy.
⁹ Department of Radiology and Diagnostic Imaging, IRCCS Regina Elena National Cancer Institute, Rome 00144, Italy.
¹⁰ Department of Radiological, Oncological and Anatomo-pathological Sciences, "Sapienza" University of Rome, Rome 00161, Italy.
¹¹ Department of Surgery, IRCCS Regina Elena National Cancer Institute, Rome 00144, Italy.
¹² Department of Maternal and Child Health and Urological Sciences, "Sapienza" University of Rome, Rome 00161, Italy.
¹³ Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome 00144, Italy.

PMID: 37076125
DOI: 10.1093/sxmrev/qead006

Abstract

Introduction: In breast cancer patients, endocrine therapy may exert a negative impact on sexual functioning in both genders, with potentially relevant consequences concerning quality of life and treatment adherence. The availability of effective interventions to maintain and/or restore sexual health in breast cancer patients is a key issue to a research agenda.

Objectives: To summarize and critically discuss the most updated and qualitatively relevant literature on the therapeutic approach to sexual impairment in breast cancer patients, with a focus on patients treated with endocrine therapy.

Methods: We searched PubMed from its inception to February 2022 for observational and intervention trials including participants with sexual dysfunctions. We were particularly interested in studies of breast cancer patients with sexual dysfunctions while undergoing endocrine therapy. We developed a search strategy with the aim of maximizing the number of articles considered for screening and potential inclusion.

Results: Forty-five studies were selected: 3 observational and 42 intervention studies. Thirty-five studies were exclusively focused on female breast cancer populations. We could not identify studies exclusively focused on or also including male breast cancer patients. Overall, in female patients, the available armamentarium encompasses vaginal lubricants, moisturizers, estrogens, dehydroepiandrosterone, CO2 laser, ospemifene, and counseling. None of these interventions has been demonstrated to completely solve sexual dysfunctions when singularly considered. More favorable outcomes have come from the combination of different therapies.

Conclusion: In female breast cancer, future research is oriented toward the gain of evidence on combined therapies and long-term data on safety issues on the most promising interventions. The lack of evidence on sexual disturbances in male breast cancer patients remains a major concern.

Keywords: breast cancer patients; breast cancer therapy; endocrine therapy; sexual dysfunction treatments; sexual function; sexual health.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Breast Neoplasms, Male*
Female
Humans
Male
Quality of Life
Sexual Behavior
Sexual Dysfunction, Physiological* / etiology
Sexual Dysfunction, Physiological* / therapy