Impact du traitement carcinologique sur le fonctionnement sexuel et l’image du corps des patientes tunisiennes en rémission d’un cancer du sein localiséImpact of Cancer Treatment on Sexual Functioning and Body Image of Tunisian Patients in Remission from Localized Breast CancerOA

The diagnosis and the management of breast cancer(BC)affect in a complex way women’s sexual lives and touch the symbol of femininity,which is very important in the constitution of the body image.Our objectives were to assess the sexual functioning and the body image of patients in remission of localized BC,to determine the links between these two parameters,and to study their relationship with the therapeutic modalities.We conducted a cross-sectional,descriptive,and analytical study in the medical oncology and radiotherapy departments of Habib Bourguiba University Hospital Center in Sfax(Tunisia),between February and August 2022.Patients were assessed based on a clinical information sheet and two psychometric scales exploring sexual functioning and body image:Female Sexual Function Index(FSFI)and Body Image Scale(BIS).The sample comprised 74 patients with a mean age of 51.55 years.They were treated by conservative or radical surgery(44.6%and 55.4%,respectively),chemotherapy(87.8%),hormone therapy(79.7%),targeted therapies(36.5%),and radiotherapy(97.3%).A rate of 51.4%of women had sexual dysfunction(SD),87.8%had hypoactive sexual desire and 36.5%had body image disorder.The body image disorder was significantly associated with DS(p=0.001).The total FSFI score(p=0.001)as well as the subscores of desire(p=0.005),arousal(p=0.003),orgasm(p=0.002),satisfaction(p<0.001),and pain(0.03)were significantly lower in patients with body image disorder.The presence of a SD was not associated with any therapeutic modality.In contrast,the presence of body image disorder was significantly associated with the radical type of surgery(p=0.003)and chemotherapy(p=0.001).Our results showed a relatively high frequency of SD and body image disorder in women in remission from BC.These two parameters seem to be closely linked,and this link would be maintained by mastectomy and chemotherapy,which appear to be therapeutic modalities incriminated in the disturbance of body image.Hence the importance of medical follow-up and psychological support for these operated patients to help them overcome all the physical,psychological,and sexual difficulties to which they are exposed.