Sexual identity after breast cancer: sexuality, body image, and relationship repercussions.

PURPOSE OF REVIEW: Breast cancer treatment indelibly alters a woman's reproductive and sexual functioning, body integrity, and the ways in which she self-identifies as a sexual being. Improved understanding of how treatment affects these aspects of a woman's health, identity, and relationships is necessary to ameliorate the effectiveness with which these issues are addressed by healthcare providers.

RECENT FINDINGS: Women with breast cancer experience significantly greater rates of sexual dysfunction and poorer body image than do healthy women. Despite this reality, most breast cancer patients are dissatisfied with the amount and quality of care they receive from their healthcare providers around sexuality. Although a substantial proportion of women endorse difficulties with sexual functioning, reproduction, and body image, each woman's experience is individual and contextual, influenced by a range of factors (e.g., age, illness stage, treatment type(s), relationship status, and others).

SUMMARY: A high proportion of women experience difficulties with sexual health and self-concept secondary to breast cancer, yet an overwhelming number report receiving inadequate or nonexistent care in these domains from their healthcare providers. There remains too wide a gap between the needs of this population and the healthcare system's response to such needs. To bridge this gap, oncology professionals across a range of disciplines must be better trained to identify, assess, and treat such difficulties, preferably using a multimodal approach that includes biological, as well as psychological and social, strategies.