Abstract / Summary
Abstract Background As survival continues to improve for women with metastatic breast cancer (mBC), understanding sexual health concerns in this population is increasingly important. Methods We conducted a cross-sectional mixed-methods study among women with mBC treated at the University of Alabama at Birmingham. Participants completed quantitative surveys, including the PROMIS Sexual Function and Satisfaction (SexFS) measures and PROMIS Global Health Scale. Semi-structured qualitative interviews were conducted with a purposively selected subgroup. Results Of the 107 participants, 67 (63%) were sexually inactive and 40 (37%) were sexually active within the prior 30 days. The most common reasons for sexual inactivity were lack of interest (54%), health-related conditions (33%), and lack of a partner (30%). Among sexually active women, 28 (70%) met criteria for sexual dysfunction. Sexual dysfunction was associated with poorer PROMIS Global Physical and Mental Health scores, whereas sexual activity status alone was not associated with significant differences. Regardless of sexual activity status, 70% considered sexual life important, and 57% reported distress related to cancer-associated sexual changes. Qualitative interviews identified five themes: sexual problems following mBC diagnosis, factors contributing to sexual problems, psychological and relationship impacts, unmet communication needs, and preferences for low-burden supportive interventions. Conclusions Sexual dysfunction and sexual inactivity are common, clinically meaningful concerns in women with mBC that remain underrecognized and undertreated. These findings underscore the need for proactive sexual health discussions and patient education about low-burden supportive interventions in clinical practice.