A longitudinal study of sexual activity and influencing factors in breast cancer patients during treatment: a trajectory analysis model

Purpose: To describe the longitudinal track of sexual activity in patients with breast cancer during treatment and its influencing factors. Methods: : A prospective longitudinal study was conducted to investigate 225 patients who were first diagnosed with breast cancer in A tumor specialty three-class hospital in Southwest China. 225 patients were evaluated for sexual activity at the time of admission and diagnosis (T 0 ) and one month (T 1 ), three months (T 2 ), six months (T 3 ), and nine months (T 4 ) after diagnosis. A trajectory analysis model (GBTM) was used to explore the changes in sexual activity in breast cancer patients. Logistic regression analysis was used to analyse the factors that affected the classification of sexual activity trajectories. Results: : The ratio of sexual activity abruptly declined from 100% at baseline to 39.1% at T 1 . The percentage of sexual activity was improved, from 51.4% at T 2 to 63.1% at T 4 . The optimal model was a 2-group trajectory of sexual activity in breast cancer patients,36.6% in the "low activity group" and 63.4% in the "high activity group." The factors influencing the grouping of sexual activity trajectories were aging ( β =0.751, P =0.004), sexual desire at baseline ( β =0.724, P =0.003), and vaginal lubrication ( β =1.177, P <0.001). Conclusions: : Research has demonstrated that the sexual activity level of breast cancer patients decreases in early stage and increases over time. Moreover, we observed that breast cancer patients had better libido and vaginal lubrication before the disease, especially those older than 50. At the same time, we suggest that the level of sexual activity in young breast cancer patients is a tremendous worthy concern during clinical work. Efficient interventions of sexual activity in advance of treatment may help to improve the sexual health of these patient populations. Implications for cancer survivors： There is a need to re-examine the evaluation steps of sexual function in breast cancer patients and provide targeted intervention services for patients.