PD04-04: Sexual Dysfunction in Women with Early Stage Breast Cancer on Endocrine Therapy: Encouraging Results from a Prospective Study.
Bibliographic record
Abstract
Abstract Background: While the side effects of endocrine therapy (ET) for early stage breast cancer (EBC) have been extensively studied, the link between ET and sexual dysfunction (SD) remains a contentious issue. Most studies have focused on documenting only the presence of problems in specific domains of endocrine symptoms (ES) (e.g. hot flushes, vaginal dryness) and sexual functioning (SF) (interest, satisfaction, arousal, lubrication) without also taking sexual distress into account. To our knowledge, there have been no prospective longitudinal studies evaluating SF and SD before the onset of ET and after treatment initiation. We report the initial 6 month results of this study of SD in women initiating ET for EBC. Methods: Hormone receptor positive EBC post-menopausal women were approached for a larger study of SF aimed at comparing the prevalence of SD across endocrine agents (tamoxifen vs aromatase inhibitor) and at evaluating the impact of anxious predisposition and ES on SD. Here we report on changes in ES, SF and SD after 6 months of ET. SF was evaluated with the Female Sexual Function Index (FSFI) while sexual distress was assessed with the Female Sexual Distress Scale. ES were measured with FACT-B ES subscale. Participants completed questionnaires prior to initiation (T0) of ET and at 6 months (T1). SD was assessed using the APA classification. Results: Between January 2009 and May 2011, 118 EBC patients entered the study and 83 have completed both assessments (mean age 62; 30% received chemotherapy). Over time, the levels of ES increased (p <0.001). Despite the worsening of ES at T1, no decline in SF was observed, this for each FSFI domain (desire, arousal, lubrication, discomfort during intercourse and satisfaction). There was no change in the percentage of women reporting 1 or more sexual problems over time (85% vs 87%, ns) nor in the percentage who were sexually distressed (32% vs 34%, ns). The prevalence of SD did not increase after 6 months of ET (T0=28% vs T1=33%, ns). There were no differences in the percentage of women who worsened (i.e., no SD at T0 but SD at T1, 12%) and those who improved (SD at T0 but no SD at T1, 7%) over time (McNemar X2, p >.5) Importantly, women classified as experiencing SD at T0 were more likely to also experience SD at T1 (OR=4.5, 95% CI=2.162 to 9.366) than women who had no SD at T0. Discussion: This is the first prospective case cohort study evaluating ES, SF and SD in women with EBC on ET. The good news for women is that although ES increased during ET (p < 0.001), this did not have a negative impact on sexual problems (85% vs 87%, ns) or SD (32% vs 34%, ns). This is encouraging news but longer follow-up of these women will provide further insight into the impact of ET on ES and SD over time (> 6 months). The impact of specific types of ET on ES, and SD will also be evaluated. Of interest, the high uptake and high completion rate (>80%) of questionnaires, indicate this is a matter of relevance and importance to women taking adjuvant ET and merits acknowledgement and sensitive discussion. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr PD04-04.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".