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Objective: This study aims to explore the trajectory of sexual dysfunction (FSD) in breast cancer patients up to 9 months after diagnosis and to analyze factors influencing the trajectory. Methods: A longitudinal study was used to investigate 225 patients with a first diagnosis of breast cancer in a tertiary care hospital in Sichuan. Patients were dynamically assessed with the Female Sexual Function Index (FSFI) at baseline, 1 month after diagnosis (T1), 3 months after diagnosis (T2), 6 months after diagnosis (T3), and 9 months after diagnosis (T4). Results: The incidence of FSD in breast cancer patients at each follow-up time point in this study was 30.7%（T0), 80.4%(T1), 81.8%(T2), 87.5%(T3), and 78%(T4), with the greatest severity of FSD at T3. The trajectory of FSD development in the 3 groups of trajectories was the optimal model, accounting for the "FSD improvement group" (22.9%), "FSD severe group" (56.1%), and "FSD worsening group" (21%). Age less than 40 years (β=2.811, P=0.048), occupation as cadre and professional (β=1.740, P=0.033), pre-treatment poorer sexual arousal (β=-2.625, P=0. 011), poorer sexual satisfaction (β=-1.555, P=0.033), and higher sexual pain (β=-1.465, P=0.032) were influencing factors for the "FSD severe group". Chemotherapy cycles ≥8 cycles (β=-1.274, P=0.040), cadre and professional occupation (β=2.172, P=0.009) were the influencing factors in the "FSD worsening group". Conclusion: Early detection of those at risk for FSD is advised for effective intervention due to the high incidence of FSD in breast cancer patients during treatment and the inability of sexual function to return to pretreatment levels at month nine of treatment. Trajectory analysis revealed that the trajectory of FSD development in breast cancer patients showed a large heterogeneity, suggesting that clinical interventions should be tailored to the individual. Priority treatment targets for intervention included patients who were under 40, ≥8 cycles of chemotherapy, professionals, low levels of pre-treatment sexual arousal and sexual satisfaction, and high levels of pre-treatment sexual pain. |
