Mastectomia e sexualidade: uma revisão integrativa <span class="so-article-trans-title" dir="auto"> Translated title: Mastectomy and sexuality: an integrative review </span>

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Abstract

Mulheres acometidas pelo câncer mamário são confrontadas com a retirada de uma parte do corpo relacionada à sexualidade. Este estudo teve por objetivo investigar o impacto do câncer de mama e da mastectomia na sexualidade da mulher por meio da análise da produção científica publicada no período de 2000 a 2009. O levantamento bibliográfico foi realizado a partir das bases de dados LILACS, MedLine e PsycINFO. Foram selecionados 29 artigos, que constituíram o corpus do estudo. Os achados foram agrupados por meio de análise de conteúdo. Os resultados evidenciaram que, após a retirada da mama, o desempenho sexual é comprometido, com redução da freqüência de intercurso sexual nos primeiros estágios do tratamento e diminuição da excitação, interesse e satisfação sexual.

Translated abstract

Women affected by breast cancer are faced with the removal of a body part related to sexuality. This study aimed to investigate the impact of breast cancer and mastectomy in women's sexuality through the analysis of scientific literature published from 2000 to 2009. The bibliographic survey was carried out in LILACS, MedLine and PsycINFO databases. Twenty nine articles were selected to constitute the corpus of the analysis. The findings were grouped by means of content analysis. The results showed that after the removal of the breast, sexual performance is compromised, with reduced frequency of sexual intercourse in the early stages of treatment and low sexual desire, interest and satisfaction.

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Comparison of psychological aspects and patient satisfaction following breast conserving surgery, simple mastectomy and breast reconstruction.

S.K. Al-Ghazal, L Fallowfield, R.W. Blamey (2000)

The aim of this study was to assess and compare the psychological outcome and satisfaction of patients whom underwent wide local excision, mastectomy alone and mastectomy with breast reconstruction. A total of 577 patients had different types of operations for primary breast cancer (254 (44%) had wide local excision, 202 (35%) had simple mastectomy and 121 (21%) had breast reconstruction). Psychosocial morbidity and satisfaction were studied retrospectively using self-evaluation questionnaires. The three different surgical groups were cross-matched into four different age group. Significant statistical differences existed between the three procedures regarding satisfaction and psychosocial morbidity (anxiety, depression, body image, sexuality and self-esteem) in favour of wide local excision followed by breast reconstruction. Greatest morbidity was seen in the mastectomy group. Patient satisfaction of cosmetic outcome and psychosocial aspects was greater with wide local excision than with breast reconstruction or mastectomy. However, since wide local excision is indicated in only a group of patients, breast reconstruction should be an option available to patients requiring mastectomy.

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Breast cancer in younger women: reproductive and late health effects of treatment.

Barbara Kahn, Mindy Bower, Laura Petersen … (2003)

In 1997, we initiated a cohort study to evaluate quality of life (QOL) and reproductive health outcomes in younger female breast cancer survivors. Using listings from two tumor registries, we recruited women with stage 0, I, or II breast cancer who were 50 years or younger at diagnosis and were also disease-free survivors for 2 to 10 years. A mailed survey questionnaire assessed medical and demographic factors, health-related QOL, mood, outlook on life, and reproductive health outcomes. We recruited 577 women, who ranged in age from 30 to 61.6 years (mean, 49.5 years) and were surveyed approximately 6 years after diagnosis. Almost three fourths had received some form of adjuvant therapy. Amenorrhea occurred frequently as a result of treatment in women > or = 40 years at diagnosis, and treatment-associated menopause was associated with poorer health perceptions. Across the cohort, physical functioning was quite good, but the youngest women experienced poorer mental health (P =.0002) and less vitality (energy; P =.03). Multiple regression analyses predicting QOL demonstrated better outcomes in African-American women, married or partnered women, and women with better emotional and physical functioning, whereas women who reported greater vulnerability had poorer QOL. Overall QOL in younger women who survive breast cancer is good, but there is evidence of increased emotional disruption, especially among the youngest women. Factors that may contribute to poorer health perceptions and QOL include experiencing a menopausal transition as part of therapy, and feeling more vulnerable after cancer.

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Quality of life at the end of primary treatment of breast cancer: first results from the moving beyond cancer randomized trial.

Mindy Bower, Beth Meyerowitz, Melissa Stanton … (2004)

During the last decade, survival rates for breast cancer have increased as a result of earlier detection and increased use of adjuvant therapy. Limited data exist on the psychosocial aspects of the transitional period between the end of primary treatment and survivorship. We investigated the baseline psychosocial status of women enrolled in a randomized trial testing two psychosocial interventions for women at the end of primary treatment. Participants, identified within 1 month after surgery (registration), provided demographic information and limited measures of quality of life. They were followed until they finished primary treatment (enrollment), at which time they completed a mailed baseline survey that included standardized measures of quality of life (including standardized scales of physical and emotional functioning), mood, symptoms, and sexual functioning. A total of 558 patients (mean age = 56.9 years) were enrolled in the study between July 1, 1999, and June 30, 2002. Health outcomes were examined according to treatment received: mastectomy with and without chemotherapy, and lumpectomy with and without chemotherapy. All statistical tests were two-sided. Among all treatment groups, patients who had a mastectomy had the poorest physical functioning at registration (P<.001) and at enrollment (P=.05). At enrollment, mood and emotional functioning were similar among all patients, with no differences by type of treatment received. At enrollment, symptoms, including muscle stiffness, breast sensitivity, aches and pains, tendency to take naps, and difficulty concentrating, were common among patients in all groups and were statistically significantly associated with poor physical functioning and emotional well-being. Sexual functioning was worse for women who received chemotherapy than for those who did not, regardless of type of surgery (P<.001). At the end of primary treatment for breast cancer, women in all treatment groups report good emotional functioning but report decreased physical functioning, particularly among women who have a mastectomy or receive chemotherapy. Clinical interventions to address common symptoms associated with treatment should be considered to improve physical and emotional functioning at the end of primary treatment for breast cancer.

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Author and article information

Journal

Journal ID (publisher-id): prc

Title: Psicologia: Reflexão e Crítica

Abbreviated Title: Psicol. Reflex. Crit.

Publisher: Curso de Pós-Graduação em Psicologia da Universidade Federal do Rio Grande do Sul (Porto Alegre, RS, Brazil )

ISSN (Print): 0102-7972

Publication date (Print and electronic): 2012

Volume: 25

Issue: 2

Pages: 339-349

Affiliations

[01] Ribeirão Preto orgnameUniversidade de São Paulo Brasil

Article

Publisher ID: S0102-79722012000200016 Publisher ID: S0102-7972(12)02500216

DOI: 10.1590/S0102-79722012000200016

SO-VID: 6dd92f89-4c33-48c7-ba17-1528eabea6de

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

History

Date received : 17 September 2010

Date accepted : 13 January 2011

Date revision received : 07 January 2011

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Figures: 0, Tables: 0, Equations: 0, References: 47, Pages: 11

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Mastectomia e sexualidade: uma revisão integrativa Translated title: Mastectomy and sexuality: an integrative review

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SciELO Brazil

Most cited references 47

Comparison of psychological aspects and patient satisfaction following breast conserving surgery, simple mastectomy and breast reconstruction.

Breast cancer in younger women: reproductive and late health effects of treatment.

Quality of life at the end of primary treatment of breast cancer: first results from the moving beyond cancer randomized trial.

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