Sexual Health and Body Image After Breast Cancer

  • Clara Hungr
  • Sharon BoberEmail author


Young breast cancer (BC) survivors are at increased risk for experiencing distressing treatment-related changes in body image and sexual function. However, these issues are not addressed for the majority of young survivors. This chapter overviews common problems around sexual function and body image and discusses how these issues are experienced within the developmental context of young adulthood. Awareness of sociocultural factors is emphasized, and concrete guidance on inquiry and intervention for young survivors is also offered.


Breast cancer Body image Sexual function Sexual health Survivorship 


  1. 1.
    Nichols HB, Schoemaker MJ, Wright LB, McGowan C, Brook MN, McClain KM, et al. The premenopausal breast cancer collaboration: a pooling project of studies participating in the National Cancer Institute Cohort Consortium. Cancer Epidemiol Biomark Prev. 2017;26(9):1360–9.CrossRefGoogle Scholar
  2. 2.
    Bloom JR, Stewart SL, Chang S, Banks PJ. Then and now: quality of life of young breast cancer survivors. Psychooncology. 2004;13(3):147–60.PubMedCrossRefPubMedCentralGoogle Scholar
  3. 3.
    Howlader N, Noone AM, Krapcho M, Miller D, Bishop K, Altekruse SF, et al. SEER Cancer statistics review, 1975–2013. Bethesda, MD: National Cancer Institute; 2016.Google Scholar
  4. 4.
    Anders CK, Fan C, Parker JS, Carey LA, Blackwell KL, Klauber-DeMore N, et al. Breast carcinomas arising at a young age: unique biology or a surrogate for aggressive intrinsic subtypes? J Clin Oncol. 2011;29(1):e18–20.PubMedCrossRefPubMedCentralGoogle Scholar
  5. 5.
    Shannon C, Smith IE. Breast cancer in adolescents and young women. Eur J Cancer. 2003;39(18):2632–42.PubMedCrossRefPubMedCentralGoogle Scholar
  6. 6.
    Anderson WF, Chatterjee N, Ershler WB, Brawley OW. Estrogen receptor breast cancer phenotypes in the surveillance, epidemiology, and end results database. Breast Cancer Res Treat. 2002;76(1):27–36.PubMedCrossRefPubMedCentralGoogle Scholar
  7. 7.
    Thewes B, Butow P, Girgis A, Pendlebury S. The psychosocial needs of breast cancer survivors; a qualitative study of the shared and unique needs of younger versus older survivors. Psychooncology. 2004;13(3):177–89.PubMedCrossRefPubMedCentralGoogle Scholar
  8. 8.
    Avis NE, Crawford S, Manuel J. Quality of life among younger women with breast cancer. J Clin Oncol. 2005;23(15):3322–30.PubMedCrossRefPubMedCentralGoogle Scholar
  9. 9.
    Katz A. The sounds of silence: sexuality information for cancer patients. J Clin Oncol. 2005;23(1):238–41.PubMedCrossRefPubMedCentralGoogle Scholar
  10. 10.
    Flynn KE, Reese JB, Jeffery DD, Abernethy AP, Lin L, Shelby RA, et al. Patient experiences with communication about sex during and after treatment for cancer. Psychooncology. 2012;21(6):594–601.PubMedCrossRefPubMedCentralGoogle Scholar
  11. 11.
    Bober SL, Varela VS. Sexuality in adult cancer survivors: challenges and intervention. J Clin Oncol. 2012;30(30):3712–9.PubMedCrossRefPubMedCentralGoogle Scholar
  12. 12.
    Dunn J, Steginga SK. Young women’s experience of breast cancer: defining young and identifying concerns. Psychooncology. 2000;9(2):137–46.PubMedCrossRefPubMedCentralGoogle Scholar
  13. 13.
    Erikson EH. Identity: youth and crisis. Oxford: Norton & Co; 1968.Google Scholar
  14. 14.
    Levinson DJ. The seasons of a man’s life. New York, NY: Random House Digital, Inc.; 1978.Google Scholar
  15. 15.
    Arnett JJ. Emerging adulthood: a theory of development from the late teens through the twenties. Am Psychol. 2000;55(5):469–80.CrossRefGoogle Scholar
  16. 16.
    Schover LR. Sexuality and body image in younger women with breast cancer. J Natl Cancer Inst Monogr. 1994;16:177–82.Google Scholar
  17. 17.
    Waskul DD, van der Riet P. The abject embodiment of cancer patients: dignity, selfhood, and the grotesque body. Symb Interact. 2002;25:487–513.CrossRefGoogle Scholar
  18. 18.
    Kasper AS. A feminist, qualitative methodology: a study of women with breast cancer. Qual Sociol. 1994;17:263–81.CrossRefGoogle Scholar
  19. 19.
    Han J, Grothuesmann D, Neises M, Hille U, Hillemanns P. Quality of life and satisfaction after breast cancer operation. Arch Gynecol Obstet. 2010;282(1):75–82.PubMedCrossRefPubMedCentralGoogle Scholar
  20. 20.
    White CA. Body image dimensions and cancer: a heuristic cognitive behavioural model. Psychooncology. 2000;9(3):183–92.PubMedCrossRefPubMedCentralGoogle Scholar
  21. 21.
    Liu J, Peh CX, Mahendran R. Body image and emotional distress in newly diagnosed cancer patients: the mediating role of dysfunctional attitudes and rumination. Body Image. 2016;20:58–64.PubMedCrossRefPubMedCentralGoogle Scholar
  22. 22.
    Przezdziecki A, Sherman KA, Baillie A, Taylor A, Foley E, Stalgis-Bilinski K. My changed body: breast cancer, body image, distress and self-compassion. Psychooncology. 2013;22(8):1872–9.PubMedCrossRefPubMedCentralGoogle Scholar
  23. 23.
    Bakht S, Najafi S. Body image and sexual dysfunctions: comparison between breast cancer patients and healthy women. Procedia Soc Behav Sci. 2010;5:1493–7.CrossRefGoogle Scholar
  24. 24.
    Tiggemann M. Body image across the adult life span: stability and change. Body Image. 2004;1(1):29–41.PubMedCrossRefPubMedCentralGoogle Scholar
  25. 25.
    Miller CT, Downey KT. A meta-analysis of heavyweight and self-esteem. Personal Soc Psychol Rev. 1999;3(1):68–84.CrossRefGoogle Scholar
  26. 26.
    Paterson CL, Lengacher CA, Donovan KA, Kip KE, Tofthagen CS. Body image in younger breast cancer survivors: asystematic review. Cancer Nurs. 2016;39(1):E39–58.PubMedPubMedCentralGoogle Scholar
  27. 27.
    Miller SJ, Schnur JB, Weinberger-Litman SL, Montgomery GH. The relationship between body image, age, and distress in women facing breast cancer surgery. Palliat Support Care. 2014;12(5):363–7.PubMedCrossRefPubMedCentralGoogle Scholar
  28. 28.
    Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002;347(16):1233–41.PubMedPubMedCentralCrossRefGoogle Scholar
  29. 29.
    Veronesi U, Cascinelli N, Mariani L, Greco M, Saccozzi R, Luini A, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med. 2002;347(16):1227–32.PubMedPubMedCentralCrossRefGoogle Scholar
  30. 30.
    Morrow M, Jagsi R, Alderman AK, Griggs JJ, Hawley ST, Hamilton AS, et al. Surgeon recommendations and receipt of mastectomy for treatment of breast cancer. JAMA. 2009;302(14):1551–6.PubMedPubMedCentralCrossRefGoogle Scholar
  31. 31.
    Gomez SL, Lichtensztajn D, Kurian AW, Telli ML, Chang ET, Keegan TH, et al. Increasing mastectomy rates for early-stage breast cancer? Population-based trends from California. J Clin Oncol. 2010;28(10):e155–7. author reply e8PubMedPubMedCentralCrossRefGoogle Scholar
  32. 32.
    Mahmood U, Hanlon AL, Koshy M, Buras R, Chumsri S, Tkaczuk KH, et al. Increasing national mastectomy rates for the treatment of early stage breast cancer. Ann Surg Oncol. 2013;20(5):1436–43.PubMedCrossRefPubMedCentralGoogle Scholar
  33. 33.
    Katipamula R, Degnim AC, Hoskin T, Boughey JC, Loprinzi C, Grant CS, et al. Trends in mastectomy rates at the Mayo Clinic Rochester: effect of surgical year and preoperative magnetic resonance imaging. J Clin Oncol. 2009;27(25):4082–8.PubMedPubMedCentralCrossRefGoogle Scholar
  34. 34.
    Tuttle TM, Habermann EB, Grund EH, Morris TJ, Virnig BA. Increasing use of contralateral prophylactic mastectomy for breast cancer patients: a trend toward more aggressive surgical treatment. J Clin Oncol. 2007;25(33):5203–9.PubMedCrossRefPubMedCentralGoogle Scholar
  35. 35.
    Herrinton LJ, Barlow WE, Yu O, Geiger AM, Elmore JG, Barton MB, et al. Efficacy of prophylactic mastectomy in women with unilateral breast cancer: a cancer research network project. J Clin Oncol. 2005;23(19):4275–86.PubMedCrossRefPubMedCentralGoogle Scholar
  36. 36.
    Anderson C, Islam JY, Elizabeth Hodgson M, Sabatino SA, Rodriguez JL, Lee CN, et al. Long-term satisfaction and body image after contralateral prophylactic mastectomy. Ann Surg Oncol. 2017;29:e18–20.Google Scholar
  37. 37.
    Yurek D, Farrar W, Andersen BL. Breast cancer surgery: comparing surgical groups and determining individual differences in postoperative sexuality and body change stress. J Consult Clin Psychol. 2000;68(4):697–709.PubMedPubMedCentralCrossRefGoogle Scholar
  38. 38.
    Engel J, Kerr J, Schlesinger-Raab A, Sauer H, Holzel D. Quality of life following breast-conserving therapy or mastectomy: results of a 5-year prospective study. Breast J. 2004;10(3):223–31.PubMedCrossRefPubMedCentralGoogle Scholar
  39. 39.
    Frost MH, Schaid DJ, Sellers TA, Slezak JM, Arnold PG, Woods JE, et al. Long-term satisfaction and psychological and social function following bilateral prophylactic mastectomy. JAMA. 2000;284(3):319–24.PubMedCrossRefPubMedCentralGoogle Scholar
  40. 40.
    Pinto AC. Sexuality and breast cancer: prime time for young patients. J Thorac Dis. 2013;5(Suppl 1):S81–6.PubMedPubMedCentralGoogle Scholar
  41. 41.
    Kedde H, van de Wiel HB, Weijmar Schultz WC, Wijsen C. Sexual dysfunction in young women with breast cancer. Support Care Cancer. 2013;21(1):271–80.PubMedCrossRefPubMedCentralGoogle Scholar
  42. 42.
    Rumsey N, Harcourt D. Body image and disfigurement: issues and interventions. Body Image. 2004;1(1):83–97.PubMedCrossRefPubMedCentralGoogle Scholar
  43. 43.
    Lansdown R, Rumsey N, Bradbury E, Carr T, Partridge J. Visibly different: coping with disfigurement. London: Hodder Arnold; 1997.Google Scholar
  44. 44.
    Langellier KM, Sullivan CF. Breast talk in breast cancer narratives. Qual Health Res. 1998;8(1):76–94.PubMedCrossRefPubMedCentralGoogle Scholar
  45. 45.
    Kwait RM, Pesek S, Onstad M, Edmonson D, Clark MA, Raker C, et al. Influential forces in breast cancer surgical decision making and the impact on body image and sexual function. Ann Surg Oncol. 2016;23(10):3403–11.PubMedCrossRefPubMedCentralGoogle Scholar
  46. 46.
    Fobair P, Stewart SL, Chang S, D’Onofrio C, Banks PJ, Bloom JR. Body image and sexual problems in young women with breast cancer. Psychooncology. 2006;15(7):579–94.PubMedCrossRefPubMedCentralGoogle Scholar
  47. 47.
    Helgeson VS, Cohen S. Social support and adjustment to cancer: reconciling descriptive, correlational, and intervention research. Health Psychol. 1996;15(2):135–48.PubMedCrossRefPubMedCentralGoogle Scholar
  48. 48.
    Manne S. Couples coping with cancer: research issues and recent findings. J Clin Psychol Med Settings. 1994;1(4):317–30.PubMedCrossRefPubMedCentralGoogle Scholar
  49. 49.
    Peters-Golden H. Breast cancer: varied perceptions of social support in the illness experience. Soc Sci Med. 1982;16(4):483–91.PubMedCrossRefPubMedCentralGoogle Scholar
  50. 50.
    Sadovsky R, Basson R, Krychman M, Morales AM, Schover L, Wang R, et al. Cancer and sexual problems. J Sex Med. 2010;7(1 Pt 2):349–73.PubMedCrossRefPubMedCentralGoogle Scholar
  51. 51.
    Katz A. Breast cancer and women’s sexuality. Am J Nurs. 2011;111(4):63–7.PubMedCrossRefPubMedCentralGoogle Scholar
  52. 52.
    Bredart A, Dolbeault S, Savignoni A, Besancenet C, This P, Giami A, et al. Prevalence and associated factors of sexual problems after early-stage breast cancer treatment: results of a French exploratory survey. Psychooncology. 2011;20(8):841–50.PubMedCrossRefPubMedCentralGoogle Scholar
  53. 53.
    Jain S, Santa-Maria CA, Gradishar WJ. The role of ovarian suppression in premenopausal women with hormone receptor-positive early-stage breast cancer. Oncology. 2015;29(7):473–8.PubMedPubMedCentralGoogle Scholar
  54. 54.
    Baumgart J, Nilsson K, Stavreus-Evers A, Kask K, Villman K, Lindman H, et al. Urogenital disorders in women with adjuvant endocrine therapy after early breast cancer. Am J Obstet Gynecol. 2011;204(1):26.e1–7.CrossRefGoogle Scholar
  55. 55.
    Rosenberg SM, Partridge AH. Premature menopause in young breast cancer: effects on quality of life and treatment interventions. J Thorac Dis. 2013;5(Suppl 1):S55–61.PubMedPubMedCentralGoogle Scholar
  56. 56.
    Anchan RM, Ginsburg ES. Fertility concerns and preservation in younger women with breast cancer. Crit Rev Oncol Hematol. 2010;74(3):175–92.PubMedCrossRefPubMedCentralGoogle Scholar
  57. 57.
    Shuster LT, Rhodes DJ, Gostout BS, Grossardt BR, Rocca WA. Premature menopause or early menopause: long-term health consequences. Maturitas. 2010;65(2):161–6.PubMedCrossRefPubMedCentralGoogle Scholar
  58. 58.
    Burstein HJ, Lacchetti C, Anderson H, Buchholz TA, Davidson NE, Gelmon KE, et al. Adjuvant endocrine therapy for women with hormone receptor-positive breast Cancer: American Society of Clinical Oncology clinical practice guideline update. J OncolPract. 2015;12:390–3.Google Scholar
  59. 59.
    Paluch-Shimon S, Pagani O, Partridge AH, Abulkhair O, Cardoso MJ, Dent RA, et al. ESO-ESMO 3rd international consensus guidelines for breast cancer in young women (BCY3). Breast. 2017;35:203–17.PubMedCrossRefPubMedCentralGoogle Scholar
  60. 60.
    Ribi K, Luo W, Bernhard J, Francis PA, Burstein HJ, Ciruelos E, et al. Adjuvant Tamoxifen plus ovarian function suppression versus Tamoxifen alone in premenopausal women with early breast Cancer: patient-reported outcomes in the suppression of ovarian function trial. J Clin Oncol. 2016;34:1601–10.PubMedPubMedCentralCrossRefGoogle Scholar
  61. 61.
    Lewis RW, Fugl-Meyer KS, Corona G, Hayes RD, Laumann EO, Moreira ED Jr, et al. Definitions/epidemiology/risk factors for sexual dysfunction. J Sex Med. 2010;7(4 Pt 2):1598–607.PubMedCrossRefPubMedCentralGoogle Scholar
  62. 62.
    Laumann EO, Paik A, Rosen RC. Sexual dysfunction in the United States: prevalence and predictors. JAMA. 1999;281(6):537–44.PubMedCrossRefPubMedCentralGoogle Scholar
  63. 63.
    Goldfarb S. Endocrine therapy and its effect on sexual function. Am Soc Clin Oncol Educ Book. 2015;2015:e575–81.CrossRefGoogle Scholar
  64. 64.
    Layeequr Rahman R, Baker T, Crawford S, Kauffman R. SOFT trial can be very hard on young women. Breast. 2015;24(6):767–8.PubMedCrossRefPubMedCentralGoogle Scholar
  65. 65.
    Francis PA, Pagani O, Fleming GF, Walley BA, Colleoni M, Lang I, et al. Tailoring adjuvant endocrine therapy for premenopausal breast cancer. N Engl J Med. 2018;379(2):122–37.PubMedPubMedCentralCrossRefGoogle Scholar
  66. 66.
    Francis PA, Regan MM, Fleming GF, Lang I, Ciruelos E, Bellet M, et al. Adjuvant ovarian suppression in premenopausal breast cancer. N Engl J Med. 2015;372(5):436–46.PubMedCrossRefPubMedCentralGoogle Scholar
  67. 67.
    Frechette D, Paquet L, Verma S, Clemons M, Wheatley-Price P, Gertler SZ, et al. The impact of endocrine therapy on sexual dysfunction in postmenopausal women with early stage breast cancer: encouraging results from a prospective study. Breast Cancer Res Treat. 2013;141(1):111–7.PubMedCrossRefPubMedCentralGoogle Scholar
  68. 68.
    Finch A, Metcalfe KA, Chiang JK, Elit L, McLaughlin J, Springate C, et al. The impact of prophylactic salpingo-oophorectomy on menopausal symptoms and sexual function in women who carry a BRCA mutation. Gynecol Oncol. 2011;121(1):163–8.PubMedCrossRefPubMedCentralGoogle Scholar
  69. 69.
    Tucker PE, Bulsara MK, Salfinger SG, Tan JJ-S, Green H, Cohen PA. Prevalence of sexual dysfunction after risk-reducing salpingo-oophorectomy. Gynecol Oncol. 2015;140(1):95–100.PubMedCrossRefPubMedCentralGoogle Scholar
  70. 70.
    Pezaro C, James P, McKinley J, Shanahan M, Young MA, Mitchell G. The consequences of risk reducing salpingo-oophorectomy: the case for a coordinated approach to long-term follow up post surgical menopause. Familial Cancer. 2012;11(3):403–10.PubMedCrossRefPubMedCentralGoogle Scholar
  71. 71.
    Dizon DS. Quality of life after breast cancer: survivorship and sexuality. Breast J. 2009;15(5):500–4.PubMedCrossRefPubMedCentralGoogle Scholar
  72. 72.
    Emilee G, Ussher JM, Perz J. Sexuality after breast cancer: a review. Maturitas. 2010;66(4):397–407.PubMedCrossRefPubMedCentralGoogle Scholar
  73. 73.
    Elmir R, Jackson D, Beale B, Schmied V. Against all odds: Australian women’s experiences of recovery from breast cancer. J Clin Nurs. 2010;19(17–18):2531–8.PubMedCrossRefPubMedCentralGoogle Scholar
  74. 74.
    Reese JB, Shelby RA, Keefe FJ, Porter LS, Abernethy AP. Sexual concerns in cancer patients: a comparison of GI and breast cancer patients. Support Care Cancer. 2010;18(9):1179–89.PubMedCrossRefPubMedCentralGoogle Scholar
  75. 75.
    Fobair P, Spiegel D. Concerns about sexuality after breast cancer. Cancer J. 2009;15(1):19–26.PubMedCrossRefPubMedCentralGoogle Scholar
  76. 76.
    Fang SY, Lin YC, Chen TC, Lin CY. Impact of marital coping on the relationship between body image and sexuality among breast cancer survivors. Support Care Cancer. 2015;23(9):2551–9.PubMedCrossRefPubMedCentralGoogle Scholar
  77. 77.
    Shaw LK, Sherman KA, Fitness J, Elder E. Factors associated with romantic relationship formation difficulties in women with breast cancer. Psychooncology. 2018;27(4):1270–6.PubMedCrossRefPubMedCentralGoogle Scholar
  78. 78.
    Kurowecki D, Fergus KD. Wearing my heart on my chest: dating, new relationships, and the reconfiguration of self-esteem after breast cancer. Psychooncology. 2014;23(1):52–64.PubMedCrossRefPubMedCentralGoogle Scholar
  79. 79.
    Christie KM, Meyerowitz BE, Maly RC. Depression and sexual adjustment following breast cancer in low-income Hispanic and non-Hispanic White women. Psychooncology. 2010;19(10):1069–77.PubMedPubMedCentralCrossRefGoogle Scholar
  80. 80.
    Giedzinska AS, Meyerowitz BE, Ganz PA, Rowland JH. Health-related quality of life in a multiethnic sample of breast cancer survivors. Ann Behav Med. 2004;28(1):39–51.PubMedCrossRefPubMedCentralGoogle Scholar
  81. 81.
    Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin. 2016;66(1):7–30.PubMedCrossRefPubMedCentralGoogle Scholar
  82. 82.
    Ashing-Giwa KT, Padilla G, Tejero J, Kraemer J, Wright K, Coscarelli A, et al. Understanding the breast cancer experience of women: a qualitative study of African American, Asian American, Latina and Caucasian cancer survivors. Psychooncology. 2004;13(6):408–28.PubMedPubMedCentralCrossRefGoogle Scholar
  83. 83.
    Taylor KL, Lamdan RM, Siegel JE, Shelby R, Hrywna M, Moran-Klimi K. Treatment regimen, sexual attractiveness concerns and psychological adjustment among African American breast cancer patients. Psychooncology. 2002;11(6):505–17.PubMedCrossRefPubMedCentralGoogle Scholar
  84. 84.
    Wilmoth MC, Sanders LD. Accept me for myself: African American women’s issues after breast cancer. Oncol Nurs Forum. 2001;28(5):875–9.PubMedPubMedCentralGoogle Scholar
  85. 85.
    Lewis PE, Sheng M, Rhodes MM, Jackson KE, Schover LR. Psychosocial concerns of young African American breast cancer survivors. J Psychosoc Oncol. 2012;30(2):168–84.PubMedPubMedCentralCrossRefGoogle Scholar
  86. 86.
    Hoffman-Goetz L. Cancer experiences of African-American women as portrayed in popular mass magazines. Psychooncology. 1999;8(1):36–45.PubMedCrossRefPubMedCentralGoogle Scholar
  87. 87.
    Masi CM, Gehlert S. Perceptions of breast cancer treatment among African-American women and men: implications for interventions. J Gen Intern Med. 2009;24(3):408–14.PubMedCrossRefPubMedCentralGoogle Scholar
  88. 88.
    Germino BB, Mishel MH, Alexander GR, Jenerette C, Blyler D, Baker C, et al. Engaging African American breast cancer survivors in an intervention trial: culture, responsiveness and community. J Cancer Surviv. 2011;5(1):82–91.PubMedCrossRefPubMedCentralGoogle Scholar
  89. 89.
    Schover LR, Rhodes MM, Baum G, Adams JH, Jenkins R, Lewis P, et al. Sisters peer counseling in reproductive issues after treatment (SPIRIT): a peer counseling program to improve reproductive health among African American breast cancer survivors. Cancer. 2011;117(21):4983–92.PubMedPubMedCentralCrossRefGoogle Scholar
  90. 90.
    Viladrich A, Yeh MC, Bruning N, Weiss R. “Do real women have curves?” paradoxical body images among Latinas in New York City. J Immigr Minor Health. 2009;11(1):20–8.PubMedCrossRefPubMedCentralGoogle Scholar
  91. 91.
    Gil RM, Vazquez CI. The Maria paradox: how Latinas can merge old world traditions with new world self-esteem. New York: Open Road Media; 2014.Google Scholar
  92. 92.
    Pompper D, Koenig J. Cross-cultural-generational perceptions of ideal body image: Hispanic women and magazine standards. J Mass Commun Quarterly. 2004;81(1):89–107.Google Scholar
  93. 93.
    Buki LP, Reich M, Lehardy EN. “Our organs have a purpose”: body image acceptance in Latina breast cancer survivors. Psychooncology. 2016;25(11):1337–42.PubMedCrossRefPubMedCentralGoogle Scholar
  94. 94.
    Ashing-Giwa KT, Padilla GV, Bohorquez DE, Tejero JS, Garcia M. Understanding the breast cancer experience of Latina women. J Psychosoc Oncol. 2006;24(3):19–52.PubMedCrossRefPubMedCentralGoogle Scholar
  95. 95.
    Martinez-Ramos GP, Biggs MJG, Lozano Y. Quality of life of Latina breast cancer survivors: from silence to empowerment. Adv Soc Work. 2013;14:82–101.CrossRefGoogle Scholar
  96. 96.
    Lopez-Class M, Perret-Gentil M, Kreling B, Caicedo L, Mandelblatt J, Graves KD. Quality of life among immigrant Latina breast cancer survivors: realities of culture and enhancing cancer care. J Cancer Educ. 2011;26(4):724–33.PubMedPubMedCentralCrossRefGoogle Scholar
  97. 97.
    Boehmer U, Glickman M, Winter M, Clark MA. Breast cancer survivors of different sexual orientations: which factors explain survivors’ quality of life and adjustment? Ann Oncol. 2013;24(6):1622–30.PubMedCrossRefPubMedCentralGoogle Scholar
  98. 98.
    Brown MT, McElroy JA. Unmet support needs of sexual and gender minority breast cancer survivors. Support Care Cancer. 2018;26(4):1189–96.PubMedCrossRefPubMedCentralGoogle Scholar
  99. 99.
    Fobair P, O’Hanlan K, Koopman C, Classen C, Dimiceli S, Drooker N, et al. Comparison of lesbian and heterosexual women’s response to newly diagnosed breast cancer. Psychooncology. 2001;10(1):40–51.PubMedCrossRefPubMedCentralGoogle Scholar
  100. 100.
    Rubin LR, Tanenbaum M. “Does that make me a woman?”: breast Cancer, mastectomy, and breast reconstruction decisions among sexual minority women. Psychol Women Q. 2011;35(3):401–14.CrossRefGoogle Scholar
  101. 101.
    Park ER, Norris RL, Bober SL. Sexual health communication during cancer care: barriers and recommendations. Cancer J. 2009;15(1):74–7.PubMedCrossRefPubMedCentralGoogle Scholar
  102. 102.
    Goldfarb SB, Abramsohn E, Andersen BL, Baron SR, Carter J, Dickler M, et al. A national network to advance the field of cancer and female sexuality. J Sex Med. 2013;10(2):319–25.PubMedPubMedCentralCrossRefGoogle Scholar
  103. 103.
    Bober S, Reese JB, Barbera L, Bradford A, Carpenter KM, Goldfarb S, et al. How to ask and what to do: a guide for clinical inquiry and intervention regarding female sexual health after cancer. Curr Opin Support Palliat Care. 2016;10:44–54.PubMedPubMedCentralCrossRefGoogle Scholar
  104. 104.
    Carter J, Goldfrank D, Schover LR. Simple strategies for vaginal health promotion in cancer survivors. J Sex Med. 2011;8(2):549–59.PubMedCrossRefPubMedCentralGoogle Scholar
  105. 105.
    Coady D, Kennedy V. Sexual health in women affected by cancer: focus on sexual pain. Obstet Gynecol. 2016;128(4):775–91.PubMedCrossRefPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Cambridge Health AllianceCambridgeUSA
  2. 2.Dana–Farber Cancer InstituteBostonUSA

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