Sexuality after breast cancer treatment: An experience of asymmetry

Background: Breast cancer survivorship is often associated with a negative impact on sexual function and sexual well-being. Given that sexual well-being contributes to quality of life—including for breast cancer survivors—it is important to address survivors’ sexual worries during the treatment process. Objective: This study explored factors that contribute to changes in sexual functioning and sexual well-being after breast cancer diagnosis and treatment in otherwise healthy patients. Design: Narrative qualitative study using thematic analysis. Method: We included 25 breast cancer survivors without severe comorbidities for individual interviews ( N  = 16) and 2 focus group discussions ( N  = 4 and N  = 6). One participant attended both an individual interview and a focus group discussion. Results: After the diagnosis of breast cancer, a sudden shift emerged in relation to life before and after breast cancer. A thematic analysis resulted in the identification of one high-level theme: asymmetry. This asymmetry was experienced in the following domains: (1) physical asymmetry in the chest region after surgery and radiotherapy, (2) sexual asymmetry; differences in how the body and mind react to sexual stimuli due to residual physical side effects and the effects of ongoing treatment: a lack of sexual desire, severe vaginal dryness and/or dyspareunia, and lack of vaginal arousal response during sexual activity, (3) life asymmetry in time- and self-management, which deprives patients from experiences that make someone feel good about oneself, (4) asymmetry in the experience in invulnerability: the reality of the sexual side effects of treatment and expectations of these side effects after being informed by a healthcare professional, and (5) relational asymmetry: asymmetry between the partners in their relationship due to role confusion and role changes. Conclusion: Breast cancer diagnosis and treatment have a distinct impact on sexual function and sexual well-being. Changes in social relationships due to the diagnosis and the physical side effects of treatment are associated with a decline in sexual well-being, which should receive more attention in research and clinical care.