Factors associated with sexual function and sexual satisfaction in young women with breast cancer.

12062 Background: Young women with breast cancer (YWBC) are vulnerable to sexual dysfunction and dissatisfaction due to age-specific psychosocial concerns and treatment side effects. This study aimed to identify factors associated with sexual health in a prospective cohort of YWBC. Methods: Patients aged ≤40 yrs with non-metastatic BC from 3 referral centers completed emotional health, quality of life (QoL), and sexual health assessments at baseline, 6 mos, 1 yr, 2-3 yrs, and 4-5 yrs post-diagnosis. Sexual activity was defined as having had intercourse in the 4 wks preceding each assessment. Female sexual dysfunction (FSD) was defined as a total score <26.55 in the Female Sexual Function Index (FSFI), while hypoactive sexual desire disorder (HSDD) was defined as a score <5 in the desire subscale. Sexual enjoyment was classified with the Sexual Satisfaction Index (SSI), with <110 indicating dissatisfaction. Results: A total of 474 patients with a median age of 36 yrs were included, of which most were married/in a domestic partnership (65%), unemployed (61%), and had an educational level <high school (51%). Most had stage II (49%) or III (39%) disease. The most common molecular subtype was HR+/HER2- (53%), followed by HR-/HER- (26%) and HR+/HER2+ (14%). The prevalence of relevant outcomes at each assessment are shown in the Table. Factors associated with being sexually inactive were low educational level (χ 2 =7.7), being single (χ 2 =112.6), having children (χ 2 =8.12), and higher treatment side effects burden ( p=0.002). Factors associated with worse sexual function were being single (χ 2 =13.8), amenorrhea (χ 2 =40.8), HADS-D ≥8 (χ 2 =11.7), and HADS-A ≥8 (χ 2 =13.9). Factors associated with lower sexual satisfaction were low educational level (χ 2 =10.3), being single (χ 2 =15.5), having undergone bilateral oophorectomy (χ 2 =5.74), amenorrhea (χ 2 =8.48), HADS-D ≥8 (χ 2 =14.98,), and HADS-A ≥8 (χ 2 =13.91). Additionally, both FSFI and SSI scores directly correlated with QoL (QLQ SumScore) and body image (QLQ-BRBI), and inversely correlated with systemic therapy side effects (QLQ-BRST) ( p<0.001). When analyzing sexual health outcomes according to type of treatment (total vs partial mastectomy, chemotherapy vs no, hormone therapy vs no, anti-HER2 agent vs no), no significant differences were found. Conclusions: Sexual dysfunction and dissatisfaction are highly prevalent in YWBC the first 5 yrs post-diagnosis. As poor sexual health correlates with inferior QoL, patients at an increased risk might benefit from early targeted interventions. Table: see text