2450 - Examining the Relationship between Cumulative Radiotherapy Dose to the Nipple-Areolar Complex and Breast Sensorisexual Function
Presenter(s)
A. V. Okorom1, T. Kapouranis2, A. Williams2,3, V. Olsen4, S. Green4, A. Saitta4, J. Lynch2, D. R. Dickstein4, K. Flynn5, and D. C. Marshall2,4; 1Icahn School of Medicine at Mount Sinai, New York, NY, 2Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, 3Division of Anatomy, Department of Surgery, University of Toronto, Toronto, ON, Canada, 4Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, 5Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
Purpose/Objective(s): Sexual dysfunction is prevalent among breast cancer patients, and preserving sexual health is vital for overall well-being and quality of life. Breast conserving therapy, which often includes endocrine therapy, has been linked to sexual toxicity, yet the contribution of radiation therapy (RT) dose to the nipple-areolar complex (NAC) to breast sensorisexual dysfunction and sexual toxicity has not been explored. This study examined the relationship between cumulative RT dose and late NAC function during sexual activity using patient-reported outcomes.
Materials/Methods: We surveyed adult female and gender-diverse patients who received local whole or partial breast EBRT for breast cancer = 12 months prior, reported breast-involved sexual activity in the last 30 days and completed the Breast Sensorisexual Function (BSF) questionnaire. BSF items allowed participants to rate measures of function (satisfaction with sensation, pleasure from contact) and dysfunction (pain, discomfort) on a 5-point Likert scale. Cumulative dosimetric parameters D95%, D50% and D2% were extracted, representing the minimum dose to the most irradiated 95%, 50% and 2% of the NAC, in equivalent dose in 2Gy fractions (a/ß=3). Correlations with function and dysfunction were evaluated with Spearman’s correlation coefficient (Rs) as follows: strong >0.6, moderate 0.4–0.59, weak 0.2–0.39.
Results: 42 sexually active participants with a median age of 65 (IQR 54-71) were included in this analysis. Among the participants, 79% indicated that their breasts held some level of importance in their sexual activity. 70% reported suboptimal (some, little or no) satisfaction with the sensation in their breasts, while 40% reported minimal or no pleasure from contact during sexual activity. Additionally, 24% of participants reported experiencing discomfort or pain. D95% demonstrated a moderate negative correlation with satisfaction with sensation (Rs = -0.46), while D50% showed a weak negative correlation (Rs = -0.38) and D2% showed no correlation. D95% alone exhibited a weak negative correlation with pleasure from breast contact (Rs = -0.32). Weak correlations were also observed between D50% and D2% and reports of breast discomfort (Rs = 0.38; Rs = 0.22) and pain (Rs = 0.33; Rs = 0.24), whereas D95% showed no correlation.
Conclusion: These preliminary findings suggest a potential relationship between higher RT doses to the NAC and late changes to breast sensorisexual function. This study represents an initial step toward clarifying the impact of RT on sexual function in breast cancer patients to inform clinical care and improve quality of life following cancer treatment.