Patterns of sexual dysfunction among breast cancer survivors five years after diagnosis: a latent class analysis of the French VICAN5 study.

PURPOSE: Sexual health concerns are highly prevalent among breast cancer survivors. Sexual dysfunction can occur from various causes, including the cancer itself, treatment side effects, and psychological distress. Therefore, this study aimed to identify distinct patterns of sexual dysfunction among women in remission from breast cancer 5 years after diagnosis using latent class analysis (LCA) and to examine factors associated with higher sexual dysfunction classes. METHODS: We conducted a cross-sectional secondary analysis of data from 356 women participating in the French nationwide VICAN5 survey 5 years after breast cancer diagnosis. Sexual dysfunction was assessed using five selected items from the Relationship and Sexuality Scale (RSS), and LCA was applied to these indicators to identify distinct dysfunction patterns. Ordinal logistic regression was used to examine factors associated with higher sexual dysfunction classes. RESULTS: A three-class model best fit the data, identifying no/low (n = 124, 34.8%), moderate (n = 133, 37.4%), and high (n = 99, 27.8%) sexual dysfunction classes. Older age at diagnosis (>50 years) (aOR, 2.30; 95% CI, 1.34-3.97; p = 0.003), frequent alcohol consumption (aOR, 2.00; 95% CI, 1.05-3.84; p = 0.036), radiotherapy (aOR, 2.36; 95% CI, 1.21-4.61; p = 0.012), current adjuvant endocrine therapy use (aOR, 1.87; 95% CI, 1.14-3.06; p = 0.013), frequent excessive sweating (aOR, 1.67; 95% CI, 1.01-2.77; p = 0.047), frequent paresthesia in the breast/arm (aOR, 1.78; 95% CI, 1.07-2.95; p = 0.026), hypnotic use (aOR, 1.66; 95% CI, 1.09-2.53; p = 0.018), and feeling less sexually attractive (aOR, 4.72; 95% CI, 3.01-7.41; p < 0.001) were associated with higher odds of being in a higher sexual dysfunction class. CONCLUSIONS: Sexual dysfunction remained common 5 years after breast cancer diagnosis, with more than one-quarter of survivors having high sexual dysfunction. These results suggest that the assessment of sexual health should be incorporated into survivorship care for breast cancer, especially in women experiencing issues with body image and persistent treatment symptoms. IMPLICATIONS FOR CANCER SURVIVORS: Sexual health should be integrated into survivorship care, including oncosexual consultations, psychosexual support for body image concerns, and management of persistent treatment-related symptoms.