Top

Supportive Care in Cancer

Published in:

01-12-2015 | Original Article

Sexual concerns of women diagnosed with breast cancer-related lymphedema

Authors: Caleb J. Winch, Kerry A. Sherman, Louise A. Koelmeyer, Katriona M. Smith, Helen Mackie, John Boyages

Published in: Supportive Care in Cancer | Issue 12/2015

Abstract

Purpose

Lymphedema is a common side effect of breast cancer treatment that may negatively impact on a woman’s physical and psychological well-being. This study aimed to understand the impact of breast cancer-related lymphedema on women’s sexual functioning, and to identify key concerns of these women regarding sexual issues.

Methods

Purposive sampling recruited 17 women aged 38–67 years with mild to severe lymphedema. Telephone interviews concerning sexual issues were transcribed verbatim and thematic analysis undertaken.

Results

Women perceived sexual concerns arising from lymphedema to exacerbate concerns arising from breast cancer. Four interrelated factors determined the extent of lymphedema’s sexual impact: (a) swelling severity and location, (b) needing to wear a compression garment, (c) body image concerns raised by lymphedema and breast cancer treatment, and (d) their sexual partner’s acceptance and supportiveness. In particular, a supportive partner was instrumental in assisting women to overcome sexual issues caused by severe swelling and/or body image concerns. Few women reported being asked about sexual issues by any health professional, and most women indicated that they were unwilling to discuss sexual concerns with health professionals, friends, or family.

Conclusions

Lymphedema had the potential to accentuate sexual issues caused by breast cancer, but most women were reluctant to discuss issues with anyone other than their partner. These findings are relevant to health professionals designing breast cancer psychosexual interventions and future research addressing lymphedema-specific sexual concerns.

DiSipio T, Rye S, Newman B, Hayes S (2013) Incidence of unilateral arm lymphoedema after breast cancer: a systematic review and meta-analysis. Lancet Oncol 14(6):500–515. doi:10.1016/s1470-2045(13)70076-7 CrossRefPubMed

Ridner SH (2013) Pathophysiology of lymphedema. Semin Oncol Nurs 29(1):4–11. doi:10.1016/j.soncn.2012.11.002 CrossRefPubMed

Ridner SH, Bonner CM, Deng J, Sinclair VG (2012) Voices from the shadows: living with lymphedema. Cancer Nurs 35(1):E18–E26. doi:10.1097/NCC.0b013e31821404c0 PubMedCentralCrossRefPubMed

Greenslade MV, House CJ (2006) Living with lymphedema: a qualitative study of women's perspectives on prevention and management following breast cancer-related treatment. Can Oncol Nurs J 16(3):165–179CrossRefPubMed

Pusic A, Cemal Y, Albornoz C, Klassen A, Cano S, Sulimanoff I, Hernandez M, Massey M, Cordeiro P, Morrow M, Mehrara B (2013) Quality of life among breast cancer patients with lymphedema: a systematic review of patient-reported outcome instruments and outcomes. J Cancer Survivorship 7(1):83–92. doi:10.1007/s11764-012-0247-5 CrossRef

Morgan PA, Franks PJ, Moffatt CJ (2005) Health-related quality of life with lymphoedema: a review of the literature. Int Wound J 2(1):47–62. doi:10.1111/j.1742-4801.2005.00066.x CrossRefPubMed

Gilbert E, Ussher JM, Perz J (2010) Sexuality after breast cancer: a review. Maturitas 66(4):397–407. doi:10.1016/j.maturitas.2010.03.027 CrossRefPubMed

Kinamore C (2008) Assessing and supporting body image and sexual concerns for young women with breast cancer: a literature review. J Radiother Pract 7(03):159–171CrossRef

Schover L (1993) Sexuality and body image in younger women with breast cancer. J Natl Cancer Inst Monogr 16:177–182

10.

Moyer A (1997) Psychosocial outcomes of breast-conserving surgery versus mastectomy: a meta-analytic review. Health Psychol 16(3):284CrossRefPubMed

11.

Ussher JM, Perz J, Gilbert E (2011) Sexual wellbeing and breast cancer in Australia: experiences of people with breast cancer and health professionals. School of Psychology University of Western Sydney, Sydney, Australia and Breast Cancer Network Australia (BCNA), Melbourne

12.

Kissane D, White K, Cooper K, Vitetta L (2004) Psychosocial impact in the areas of body image and sexuality for women with breast cancer. The National Breast Cancer Centre, Sydney

13.

Bartula I, Sherman KA (2013) Screening for sexual dysfunction in women diagnosed with breast cancer: systematic review and recommendations. Breast Cancer Res Treat 141(2):173–185. doi:10.1007/s10549-013-2685-9 PubMedCentralCrossRefPubMed

14.

Ussher JM, Perz J, Gilbert E (2012) Changes to sexual well-being and intimacy after breast cancer. Cancer Nurs 35(6):456–465. doi:10.1097/NCC.0b013e3182395401 CrossRefPubMed

15.

Przezdziecki A, Sherman KA, Baillie A, Taylor A, Foley E, Stalgis-Bilinski K (2013) My changed body: breast cancer, body image, distress and self-compassion. Psycho-Oncology 22(8):1872–1879. doi:10.1002/pon.3230 CrossRefPubMed

16.

Wetzig N, Gill PG, Zannino D, Stockler MR, Gebski V, Ung O, Campbell I, Simes RJ (2014) Sentinel lymph node based management or routine axillary clearance? Three-year outcomes of the RACS sentinel node biopsy versus axillary clearance (SNAC) 1 trial. Ann Surg Oncol 1–7

17.

Radina E, Watson W, Faubert K (2008) Lymphoedema and sexual relationships in mid/later life. J Lymphoedema 3(2):21–30

18.

Yang EJ, Kim SW, Heo CY, Lim JY (2011) Longitudinal changes in sexual problems related to cancer treatment in Korean breast cancer survivors: a prospective cohort study. Support Care Cancer 19(7):909–918. doi:10.1007/s00520-010-0885-y CrossRefPubMed

19.

Panjari M, Bell RJ, Davis SR (2011) Sexual function after breast cancer. J Sex Med 8(1):294–302. doi:10.1111/j.1743-6109.2010.02034.x CrossRefPubMed

20.

Fu MR, Ridner SH, Hu SH, Stewart BR, Cormier JN, Armer JM (2013) Psychosocial impact of lymphedema: a systematic review of literature from 2004 to 2011. Psychooncology 22(7):1466–1484. doi:10.1002/pon.3201 PubMedCentralCrossRefPubMed

21.

International Society of Lymphology (2013) The diagnosis and treatment of peripheral lymphedema: 2013 Consensus Document of the International Society of Lymphology. Lymphology 46(1):1–11

22.

Braun V, Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3(2):77–101. doi:10.1191/1478088706qp063oa CrossRef

23.

Glaser BG, Strauss AL (2009) The discovery of grounded theory: strategies for qualitative research. Transaction Books, Piscataway

24.

Alder J, Zanetti R, Wight E, Urech C, Fink N, Bitzer J (2008) Sexual dysfunction after premenopausal stage I and II breast cancer: do androgens play a role? J Sex Med 5(8):1898–1906. doi:10.1111/j.1743-6109.2008.00893.x CrossRefPubMed

25.

Boehmer U, Timm A, Ozonoff A, Potter J (2012) Explanatory factors of sexual function in sexual minority women breast cancer survivors. Ann Oncol 23(11):2873–2878. doi:10.1093/annonc/mds099 CrossRefPubMed

26.

Schover LR, Rhodes MM, Baum G, Adams JH, Jenkins R, Lewis P, Jackson KE (2011) Sisters Peer Counseling in Reproductive Issues After Treatment (SPIRIT): a peer counseling program to improve reproductive health among African American breast cancer survivors. Cancer 117(21):4983–4992. doi:10.1002/cncr.26139 PubMedCentralCrossRefPubMed

27.

Gilbert E, Ussher JM, Perz J (2010) Renegotiating sexuality and intimacy in the context of cancer: the experiences of carers. Arch Sex Behav 39(4):998–1009. doi:10.1007/s10508-008-9416-z CrossRefPubMed

28.

Garrusi B, Faezee H (2008) How do Iranian women with breast cancer conceptualize sex and body image? Sex Disabil 26(3):159–165CrossRef

29.

Zee B, Huang C, Mak S, Wong J, Chan E, Yeo W (2008) Factors related to sexual health in Chinese women with breast cancer in Hong Kong. Asia‐Pac J Clin Oncol 4(4):218–226

30.

Hawkins Y, Ussher J, Gilbert E, Perz J, Sandoval M, Sundquist K (2009) Changes in sexuality and intimacy after the diagnosis and treatment of cancer: the experience of partners in a sexual relationship with a person with cancer. Cancer Nurs 32(4):271–280CrossRefPubMed

Title: Sexual concerns of women diagnosed with breast cancer-related lymphedema
Authors: Caleb J. Winch
Kerry A. Sherman
Louise A. Koelmeyer
Katriona M. Smith
Helen Mackie
John Boyages
Publication date: 01-12-2015
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 12/2015
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-015-2709-6

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 12/2015

Cognitive strategies and quality of life of patients with high-grade glioma

Guideline sheets on the side effects of anticancer drugs are useful for general practitioners

Cancer rehabilitation and palliative care: critical components in the delivery of high-quality oncology services

Early percutaneous endoscopic gastrostomy and nutritional supplementation for patients with head and neck cancer: an Italian survey of head and neck radiation oncologists

How to implement quality indicators successfully in palliative care services: perceptions of team members about facilitators of and barriers to implementation

Relations between arthralgia and fear of recurrence: results of a cross-sectional study of breast cancer patients treated with adjuvant aromatase inhibitors therapy

Keynote webinar | Spotlight on antibody–drug conjugates in cancer