Sexual behavior characteristics in breast cancer patients: NHANES study analysis.

Abstract

e24071 Background: Breast cancer is the most common malignancy among women, excluding skin cancer, with one in eight women diagnosed in their lifetime in the United States. Advances in early detection have improved survival rates, yet many patients experience distressing symptoms and a decline in quality of life. Sexual health is often affected by both the cancer diagnosis and its treatment but remains inadequately addressed during routine follow-up care. Factors influencing sexual health include health, relationships, communication, sexual history, self-esteem, medications, and menopausal status. Understanding sexual health in breast cancer patients helps healthcare providers assess needs and promote comprehensive care. Methods: Used National Health and Nutrition Examination Survey data 1999–2016 to identify females who completed the sexual behavior questionnaire, separating them by breast cancer status. Descriptive analyses calculated proportions of categorical variables. T-tests and ANOVA compared continuous variables, and chi-square tests compared categorical variables. Survey-weighted regressions evaluated associations. Statistical significance was defined as p < 0.05. Results: 16,631 females without breast cancer and 245 with breast cancer. Breast cancer patients were older (56.5 vs 40.7 years, p < 0.05) and higher rates of diabetes (13.5% vs 8.3%), hypertension (46.5% vs 26.4%), and smoking (45.6% vs 36.8%, p < 0.05), more likely to have had a hysterectomy (32.6% vs 19.1%, p < 0.05), used hormones (27.7% vs 15.2%, p < 0.05), and total oophorectomy (23% vs 11.7%, p < 0.05). Sexually active status was similar in both groups (96% vs 98%, p < 0.05). Homosexual identity slightly higher breast cancer patients (13% vs 16%, p = 0.6). Mean lifetime male sex partners was higher for non breast cancer patients (18 vs 8.3, p = 0.5). Mean last year male partners was lower for breast cancer patients (3.6 vs 2, p < 0.05). Mean female partners was higher for non breast cancer patients (9 vs 4, p > 0.05). Age at first sexual intercourse similar (17.7 vs 18.7, p = 0.99). Genital herpes (5.1% vs 6.7%, p > 0.5), genital warts (5.4% vs 4.5%, p = 0.7), gonorrhea (0.39% vs 0%, p = 0.9), and chlamydia (1.46% vs 0.75%, p = 0.7) rates were similar between the groups. Menopausal status and hormone use did not significantly affect lifetime male partners (p = 0.34). Sexual activity was lower in postmenopausal breast cancer patients (p < 0.05). Hysterectomy status was associated with fewer male partners (p < 0.05). Conclusions: Study highlights differences in sexual behavior between breast cancer and non-breast cancer patients. Breast cancer status impacts behaviors such as recent sexual partnerships but does not significantly affect lifetime partners or STI prevalence. The potential impact of surgical interventions on sexual health was noted. These findings emphasize the need to explore causal pathways linking sexual behavior, comorbidities, and breast cancer to better understand the impact on sexual function and quality of life.