Research evaluates impact of surgical modality on breast-specific sensuality


Does the type of surgery used to treat breast cancer impact a woman's sensuality and sexual function in survivorship? New research from Women & Infants Hospital analyzed the association of surgical modality with sexual function and found that breast-specific sensuality and appearance satisfaction are better with lumpectomy and may correlate with improved sexual function post-operatively.

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.


About Women & Infants Hospital

Women & Infants Hospital of Rhode Island, a Care New England hospital, is one of the nation's leading specialty hospitals for women and newborns. A major teaching affiliate of The Warren Alpert Medical School of Brown University for obstetrics, gynecology and newborn pediatrics, as well as a number of specialized programs in women's medicine, Women & Infants is the ninth largest stand-alone obstetrical service in the country and the largest in New England with approximately 8,500 deliveries per year. A Designated Baby-Friendly® USA hospital, U.S.News & World Report 2014-15 Best Children's Hospital in Neonatology and a 2014 Leapfrog Top Hospital, in 2009 Women & Infants opened what was at the time the country's largest, single-family room neonatal intensive care unit.

Women & Infants and Brown offer fellowship programs in gynecologic oncology, maternal-fetal medicine, urogynecology and reconstructive pelvic surgery, neonatal-perinatal medicine, pediatric and perinatal pathology, gynecologic pathology and cytopathology, and reproductive endocrinology and infertility. It is home to the nation's first mother-baby perinatal psychiatric partial hospital, as well as the nation's only fellowship program in obstetric medicine.

Women & Infants has been designated as a Breast Imaging Center of Excellence by the American College of Radiography; a Center of Excellence in Minimally Invasive Gynecology; a Center of Biomedical Research Excellence by the National Institutes of Health (NIH); and a Neonatal Resource Services Center of Excellence. It is one of the largest and most prestigious research facilities in high risk and normal obstetrics, gynecology and newborn pediatrics in the nation, and is a member of the National Cancer Institute's Gynecologic Oncology Group and the Pelvic Floor Disorders Network.

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