Abstract / Summary
Breast cancer frequently affects sexual well-being, with long-lasting consequences for intimacy, relationship functioning, and quality of life. Although couple-based psychosexual interventions are increasingly recommended within survivorship care, little is known about the therapeutic principles underpinning these programs. This systematic review aimed to identify, describe, and critically synthesize couple-based psychosexual interventions designed to improve sexual well-being after breast cancer, with particular emphasis on their therapeutic architecture, core components, and methodological characteristics. Following PRISMA 2020 guidelines, a systematic search was conducted in Web of Science Core Collection, PubMed, PsycINFO, and Cochrane Library. Five studies met the eligibility criteria. Methodological quality was assessed using the Mixed Methods Appraisal Tool (MMAT 2018). Despite substantial methodological heterogeneity, the interventions consistently involved both partners and shared key therapeutic components, including psychoeducation, communication skills training, intimacy enhancement, and partner support. More recent interventions additionally incorporated cognitive-behavioral and acceptance-based strategies, reflecting a shift from symptom-oriented approaches toward biopsychosocial and relational models of sexual recovery. Overall, the available evidence suggests that couple-based psychosexual interventions may improve sexual and relational outcomes. However, conclusions remain limited by the small number of studies, heterogeneous intervention protocols, and scarce long-term follow-up. These findings identify common therapeutic components that may guide the development of more theoretically grounded, standardized, and clinically applicable psychosexual interventions for couples coping with breast cancer.