[Sexual/intimate morbidity under tamoxifen and risk of weakened treatment adherence in premenopausal women with HR+ breast cancer: An underestimated and potentially modifiable factor].
TL;DR
Sexual/intimate morbidity associated with tamoxifen is an underestimated but modifiable factor that weakens treatment adherence and quality of life in premenopausal women with hormone-sensitive breast cancer.
Abstract
INTRODUCTION In premenopausal women with hormone-sensitive breast cancer, long-term tamoxifen is a standard treatment. However, its adverse effects, particularly on sexual/intimate life, can affect medication adherence.
Objective
To evaluate the impact of this specific toxicity in this population.
Methods
A cross-sectional exploratory study of 46 women aged 18 to 50 years receiving tamoxifen for hormone-dependent breast cancer. The validated EORTC QLQ-BR23 and EORTC SHQ-C22 questionnaires were supplemented with eight questions focusing on the links between information received and patient-caregiver communication with tamoxifen adherence. Scores were calculated according to EORTC guidelines.
Results
Sexual/intimate morbidity affected more than half of the patients (who were not informed): decreased libido (78%), fatigue impacting sexuality (81%), vaginal dryness (57%), and dyspareunia (52%). Sexual satisfaction decreased from 80% before the illness to 40% during treatment. Regarding adherence, nearly four out of ten participants considered stopping tamoxifen due to this toxicity, and 35% interrupted it temporarily. Only 29% were able to discuss these difficulties with a healthcare professional.
Conclusion
Sexual/intimate morbidity associated with tamoxifen is an underestimated but modifiable factor that weakens treatment adherence. Screening for it through a simple interview and its routine integration into supportive oncology care are two recommended levers for secondary and tertiary prevention of breast cancer by optimizing tamoxifen adherence and quality of life.