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This study aimed to assess prevalence and types of sexual dysfunction in young breast cancer (BC) survivors and to analyse the impact of cancer diagnosis and treatment’s related factors on sexual functioning.

We performed a cross-sectional study including all young BC patients (≤40 year-old) who have been irradiated in the Ariana's Radiation Oncology Department since at least 6 months. Patients were recruited to fill in the Female Sexual Function Index (FSFI) in its validated Arabic translated version. Demographic and clinical data were collected. Statistical association between these variables and sexual dysfunction was analysed.

One hundred and two medical records of eligible breast cancer patients were reviewed. Only 40 (39.2%) patients accepted to answer the questionnaire. Mean age was 36 years. Eighty-two percent of patients had stage T1-T2 BC and 56% had positive regional lymph nodes. Radical mastectomy was performed in 73% of cases. Thirty-nine (97%) patients underwent chemotherapy which was poorly to moderately tolerated in 55% of cases. Endocrine therapy was prescribed for 31 (77%) women with ovarian function suppression in 96,77% of the cases. All women underwent adjuvant hypofractionated RT. Twenty-eight (70%) patients experienced skin toxicity: 14 patients had skin colour changes, 8 reported breast asymmetry and 7 patients had skin dryness. Only 2 patients underwent breast reconstruction.

Sexual dysfunction before BC diagnosis was reported in 2 patients. The mean FSFI full score was 24.01 (2-33). Fifty-five percent of participants had female sexual dysfunction with FSFI full score <26.55. Hypoactive sexual desire disorder was reported in 92% of cases with mean desire score of 3,5 (1.2-5.4), whereas 60% had arousal disorder. Ten patients (40%) reported lubrication difficulties. The mean orgasm and satisfaction scores were 4.23 and 4.44 respectively, with 44% of women reporting a subjective deterioration of sexual well-being. Although not statistically significant, women who underwent radical surgery and ovarian suppression function tended to have poorer sexual function. Neither chemotherapy, radiotherapy nor treatment’s related toxicities were associated to sexual dysfunction.

This study showed high prevalence of female sexual disorders in young BC survivors. BC diagnosis and treatment may significantly impair patient’s sexual function. Assessment and management of sexual dysfunction should be part of our standard care. Larger studies with further analysis of sexual dysfunction predictors are required to improve BC survivor’s sexual outcomes and quality of life.