BackgroundThis cross-sectional, nested cohort study assessed Female Sexual Function Index (FSFI) scores in postmenopausal women with breast cancer receiving primary chemotherapy.MethodsThe FSFI questionnaire was administered to 24 postmenopausal women one month after diagnosis of breast cancer (post-diagnosis group) and one month after completion of the first cycle of primary anthracyclin-based chemotherapy (post-chemotherapy group). Scores were compared to those of 24 healthy postmenopausal women seeking routine gynecological care (control group). All patients were sexually active at the time of enrollment. Mean age was 57.29 ± 11.82 years in the breast cancer group and 52.58 ± 7.19 years in the control group.ResultsScores in all domains of the FSFI instrument were significantly lower in the post-diagnosis group than in controls (−41.3%, p < 0.001). A further major reduction in FSFI scores was evident on completion of one cycle of primary chemotherapy (down 46.7% from post-diagnosis scores, p < 0.003), again in all domains. Six patients (25%) ceased all sexual relations, in a significant change from baseline (p < 0.001). After one chemotherapy cycle, a further five patients ceased sexual activity, for a total of 11 (45.8%) participants – a borderline significant difference (p = 0.063).ConclusionThe present study shows that female sexual function as assessed by the FSFI declines significantly at two distinct points in time: upon diagnosis of breast cancer and after administration of systemic chemotherapy.

Partners' judgments of patients' QOL may be important in some circumstances, particularly when patients are not able to answer questions about their own QOL because of cognitive or functional limitations. Nurses must be aware that partners are the most frequent informal caregivers and should be included in the entire treatment process.

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Certain mutations in BRCA1 and BRCA2 genes are frequent in the Ashkenazi Jewish population. Several factors contribute to this increased frequency, including consanguineous marriages and an event known as a “bottleneck”, which occurred in the past and caused a drastic reduction in the genetic variability of this population. Several studies were performed over the years in an attempt to elucidate the role of BRCA1 and BRCA2 genes in susceptibility to breast cancer. The aim of this study was to estimate the carrier frequency of certain common mutations in the BRCA1 (185delAG and 5382insC) and BRCA2 (6174delT) genes in an Ashkenazi Jewish population from Porto Alegre, Brazil. Molecular analyses were done by PCR followed by RFLP (ACRS). The carrier frequencies for BRCA1 185delAG and 5382insC were 0.78 and 0 respectively, and 0.4 for the BRCA2 6174deT mutation. These findings are similar to those of some prior studies but differ from others, possibly due to excluding individuals with a personal or family history of cancer. Our sample was drawn from the community group and included individuals with or without a family or personal history of cancer. Furthermore, increased dispersion among Ashkenazi subpopulations may be the result of strong genetic drift and/or admixture. It is therefore necessary to consider the effects of local admixture on the mismatch distributions of various Jewish populations.

The 30-year experience in improving detection of breast cancer in the Breast Unit of the Hospital de Clínicas, Federal University of Rio Grande do Sul, Brazil (1972-2002) is reported. We retrospectively analyzed the behavior of surrogate parameters of early breast cancer detection, such as the mean tumor diameter at diagnosis, clinical staging, as well as the percentage of breast conservative surgery along this period of three decades. From 2,103 identified women, 1,607 women met our criteria for study entry and had follow-up information, constituting our study cohort. Statistical tests were two-sided and considered significant at p < 0.05. There was a decrease of about 0.8 cm in the median tumor diameter over this 30-year period. The incidence of early-stage tumors increased progressively over time, and the percentage of patients presenting with stage I breast cancer doubled in 30 years. The Halsted procedure that represented 11.5% of surgeries in the 1970s is a very rare procedure nowadays (<1% of cases). Modified radical mastectomy was the procedure applied in about 50% of women with invasive breast cancer during these 30 years of observation. Notably, breast conservative surgery increased from 17.3% in the 1970s to 43.2% in the 2000s, while the decrease in tumor size and clinical staging was accompanied by an increased number of breast conservative surgical procedures. In geographic areas where coordinated preventive efforts are not thoroughly available, analysis of subsets of the patient population using tumor size as a surrogate represents an indirect way to observe long-term effects of prevention. The present study shows that tumor size is a surrogate for populations from developing countries too and gives scientific support for the design of continuous comprehensive programs of breast cancer prevention in this setting.