Breast-Conserving Surgery Boosts Sexual Well-Being Over Reconstruction, Study Finds - Video

For women with breast cancer, breast-conserving therapy (BCT) is associated with improved sexual well-being, compared to mastectomy followed by breast reconstruction, reports a study in the March issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons.

Many women with breast cancer have sexual health concerns. In previous studies, up to 85% of breast cancer patients report

sexual dysfunction but few receive any medical guidance for sexual dysfunction. For many patients, BCT – sometimes called "lumpectomy" – offers an effective alternative to mastectomy. For those who undergo mastectomy, breast reconstruction has established benefits in terms of quality of life and self-esteem.

Few studies of breast cancer treatment have focused on sexual well-being, especially in comparing the outcomes of BCT versus postmastectomy breast reconstruction (PMBR). Using validated BREAST-Q questionnaire, the researchers analyzed sexual well-being scores for 15,857 patients who underwent breast cancer surgery.

About 54% of patients underwent BCT and 46% had PBMR. Scores on a sexual well-being subscale – addressing sexual attractiveness, sexual confidence, and comfort level during sex – were compared between groups, including long-term follow-up when available.

Overall, scores averaged 7.6 points higher in the BCT group. Sexual well-being was significantly correlated with scores in other BREAST-Q domains, including physical well-being of the chest, satisfaction with breasts, and psychosocial well-being.

Despite the impact on sexual well-being, only 3.5% of the BCT group and 5.4% of the PBMR group received sexual medicine consultation, which was available from a dedicated service at the authors' cancer center

The authors also emphasize the need to consider and discuss the impact of breast cancer surgery on sexual well-being. They then concluded that although many patients have low sexual health, most do not receive sexual medicine consultation, suggesting an opportunity for providers to improve breast cancer patients' sexual health.

Ref: Stern, Carrie S. MD, Kim, Minji BS et al. Breast-Conserving Therapy Preserves Sexual Well-Being More than Postmastectomy Breast Reconstruction: Trends, Factors, and Interventions. Plastic and Reconstructive Surgery 155(3):p 407-420, March 2025. | DOI: 10.1097/PRS.0000000000011657