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Effect of Surgery and Adjuvant Therapy in Reproductive and Sexual Dysfunction in Pre-menopausal Women with Breast Cancer

Shahid Ahmed, Nayyer Iqbal, Mohamed Emara and Duc Le

Breast cancer is one of the most common cancers in women. Approximately twenty five percent breast cancer occurs during the reproductive and perimenopausal years. Surgery is the primary treatment of breast cancer. In addition, based on stage and biology of the disease, chemotherapy, radiation, endocrine therapy and biologics are recommended to reduce recurrence and cancer-related mortality. Although survival rates of women with breast cancer has significantly improved, the potential late adverse effects of adjuvant treatment and their impact on quality of life of breast cancer survivors have become increasingly important. Among premenopausal women with breast cancer, management of sexual dysfunction and fertility presents a challenge. The principal mechanisms that systemic therapy affect sexual function and fertility in women with breast cancer is ovarian suppression. In addition, cancer therapy alters anatomy and causes mucosal or skin changes that result in impaired sexual and reproductive health. In this article we review the effect of surgery and adjuvant therapy on reproductive and sexual health of young breast cancer survivors and briefly discuss various treatment options.