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Trending Clinical Topic: Breast Cancer
October is Breast Cancer Awareness Month, and several recent studies have tackled various key aspects of the condition. Findings about intimacy and body image, the impact of exercise as prevention, brain metastasis, and treatment options sparked interest and made the disease the top trending clinical topic of the week. A presentation at the European Society for Medical Oncology Annual Meeting 2022 tackled a subject that is too often overlooked when it comes to the well-being of patients with breast cancer: sexual health (see Infographic below).
To determine the extent of sexual dysfunction among women with breast cancer, Maria Alice Franzoi, MD, analyzed data concerning sexuality from the CANTO cohort study. Study participants answered the EORTC-QLQ-BR23 quality-of-life questionnaire at the time of diagnosis, 1 year after diagnosis, and 2 years after diagnosis. The findings showed that sexual dysfunction worsens in the time after diagnosis. Four factors were assessed: poor body image, poor sexual functioning (activity and desire), lack of sexual pleasure, and a complete lack of sexual activity. "Seventy-five percent of patients reported at least one of the four concerns during the study," noted Franzoi during her presentation. "Sexual dysfunction is a major unmet need with a significant impact on quality of life," said Maryam Lustberg, MD, an oncologist at Yale School of Medicine in New Haven, Connecticut, who was invited to discuss the results at the conference.
These findings were echoed in a recent Italian study. When women with breast cancer were asked about the relationship they had with their body, 48.9% noted that the disease had an impact on their body image, and 7.2% had difficulty when it came to recognizing their own body. On the topic of sexuality, 55.4% said that their sex life had gotten worse after diagnosis, and 18.8% reported significant sexual dissatisfaction. The authors advised clinicians to encourage communication about sexuality — a topic that is regularly overlooked and not included in discussions with patients.
In terms of risk factors, new findings provide stronger evidence of causality between sedentary lifestyle and breast cancer development. Investigators used individual-level case-control data and performed two-sample Mendelian randomization — a study method that assesses causality by using genetic variants as proxies for particular risk factors. In this study, genetic variants were used as proxies for lifelong physical activity levels and sedentary behaviors. Patients with greater genetic predisposition to higher overall activity levels had a 41% lower overall breast cancer risk (odds ratio [OR], 0.59). Genetically predicted vigorous activity was associated with a 38% lower risk for premenopausal and perimenopausal breast cancer (OR, 0.62 for 3 or more days vs 0 days of self-reported days per week). In contrast, greater genetically predicted sedentary time was associated with a 77% higher risk for hormone receptor–negative breast cancer risk (OR, 1.77), including triple-negative breast cancer (TNBC), for which the risk was 104% higher (OR, 2.04).
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Cite this: Ryan Syrek. Trending Clinical Topic: Breast Cancer - Medscape - Oct 07, 2022.