Sexuality and Psychological Well-being in Breast Cancer Survivors: Insights from the Biopsychosocial Perspective
DOI:
https://doi.org/10.32635/2176-9745.RBC.2025v71n3.5089Keywords:
Mental Health/education, Sexuality/psychology, Breast Neoplasms/psychology, Women’s Health, Qualitative ResearchAbstract
Introduction: Breast cancer survivors face psychological, social, and cultural challenges, often related to anxiety, depression, and sexuality issues. These experiences are influenced by physical and emotional changes resulting from oncological treatment, as well as sociocultural taboos. Objective: To highlight the importance of the biopsychosocial model in managing the psychological and social impacts on women who have survived breast cancer and participated in the WaterMama study, emphasizing the essential role of health education groups in promoting the emotional and sexual well-being of these patients and providing practical insights for healthcare professionals seeking to adopt a more integrative and humanized approach. Method: Descriptive study with a qualitative approach, based on the biopsychosocial model. The investigation focused on analyzing the interactions and mutual support established among these women in health education groups, with an emphasis on the psychological and social dynamics experienced by the participants. Results: Group interactions and peer support emerged as key factors in reducing psychological and social impacts, promoting greater social connection, resilience, and quality of life. The adoption of the biopsychosocial model enabled a comprehensive approach to the needs of these women, highlighting the relevance of sexuality as an integral part of mental health and well-being. Conclusion: Integrative strategies, such as support and health education groups, are essential components in the care of this population, with significant benefits for their physical, psychological, and social health.
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Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229-63. doi: https://doi.org/10.3322/caac.21834 DOI: https://doi.org/10.3322/caac.21834
Santos MO, Lima FCS, Martins LFL, et al. Estimativa de incidência de câncer no Brasil, 2023-2025. Rev Bras Cancerol. 2023;69(1):e-213700. doi: https://doi.org/10.32635/2176-9745.RBC.2023v69n1.3700 DOI: https://doi.org/10.32635/2176-9745.RBC.2023v69n1.3700
Giaquinto AN, Sung H, Newman LA, et al. Breast cancer statistics 2024. CA Cancer J Clin. 2024;74:477-95. doi: https://doi.org/10.3322/caac.21863 DOI: https://doi.org/10.3322/caac.21863
Siegel RL, Miller KD, Fuchs HE, et al. Cancer statistics, 2022. CA Cancer J Clin. 2022;72(1):7-33. doi: https://doi.org/10.3322/caac.21708 DOI: https://doi.org/10.3322/caac.21708
Durosini I, Triberti S, Savioni L, et al. The role of emotion-related abilities in the quality of life of breast cancer survivors: a systematic review. Int J Environ Res Public Health. 2022;19(19):12704. doi: https://doi.org/10.3390/ijerph191912704 DOI: https://doi.org/10.3390/ijerph191912704
Haddou MB, El Mouaddib H, Haddou ZB, et al. Assessment of mental well-being and psychological distress in moroccan breast cancer patients. Dement Neuropsychol. 2024;18:e20240145. DOI: https://doi.org/10.1590/1980-5764-dn-2024-0145
Graham J. Breast Cancer: The psychological impact of diagnosis, treatment, and remission. cureus. 2024;16(10):e70814. doi: https://doi.org/10.7759/cureus.70814 DOI: https://doi.org/10.7759/cureus.70814
Fortin J, Leblanc M, Elgbeili G, et al. the mental health impacts of receiving a breast cancer diagnosis: a meta-analysis. Br J Cancer. 2021;125(11):1582-92. DOI: https://doi.org/10.1038/s41416-021-01542-3
Dinapoli L, Colloca G, Di Capua B, et al. Psychological aspects to consider in breast cancer diagnosis and treatment. Curr Oncol Rep. 2021;23(3):38. DOI: https://doi.org/10.1007/s11912-021-01049-3
Franklin M, Lewis S, Townsend J, et al. Making the unbearable, bearable: Qualitative examination of patient, family and nurses’ perspectives on the role and value of specialist metastatic breast care nurses. Eur J Oncol Nurs. 2024;69:102523. doi: https://doi.org/10.1016/j.ejon.2024.102523 DOI: https://doi.org/10.1016/j.ejon.2024.102523
Lee SJ, Jin DL, Kim YA, et al. How should the healthcare system support cancer survivors? Survivors’ and health professionals’ expectations and perception on comprehensive cancer survivorship care in Korea: a qualitative study. BMC Cancer. 2023;23(1):1255. DOI: https://doi.org/10.1186/s12885-023-11736-y
Rodrigues T, Moreira MT, Lima A, et al. Contributions of a Rehabilitation Nursing Program in the Self-Care of Women Undergoing Breast Surgery. Nurs Rep. 2023;13(2):913-22. DOI: https://doi.org/10.3390/nursrep13020080
Lyu MM, Siah RCJ, Lam ASL, et al. The effect of psychological interventions on fear of cancer recurrence in breast cancer survivors: a systematic review and meta-analysis. J Adv Nurs. 2022;78(10):3069-82. DOI: https://doi.org/10.1111/jan.15321
Al-Alawi KS, Al-Azri M, Al-Fahdi A, et al. Effect of psycho-educational intervention to reduce anxiety and depression at postintervention and follow-up in women with breast cancer: a systematic review and meta-analysis. Semin Oncol Nurs. 2022;38(6):151315. DOI: https://doi.org/10.1016/j.soncn.2022.151315
O’Sullivan CC, Larson NL, Vierkant RA, et al. Advocate-BREAST: advocates and patients’ advice to enhance breast cancer care delivery, patient experience and patient centered research by 2025. Arch Public Health. 2024;82(1):119. DOI: https://doi.org/10.1186/s13690-024-01351-z
Barbalho D, Polidorio N, Mori L, et al. Breast conservation and oncoplastic surgery are associated with improved quality of life. Front Oncol. 2024;14:1465769. doi: https://doi.org/10.3389/fonc.2024.1465769 DOI: https://doi.org/10.3389/fonc.2024.1465769
Ilie G, Knapp G, Davidson A, et al. The cancer patient empowerment program: a comprehensive approach to reducing psychological distress in cancer survivors, with insights from a mixed-model analysis, including implications for breast cancer patients. Cancers (Basel). 2024;16(19):3373. DOI: https://doi.org/10.3390/cancers16193373
Omari M, Amaadour L, El Asri A, et al. Psychological distress and coping strategies in breast cancer patients under neoadjuvant therapy: a systematic review. Womens Health (Lond). 2024;20:17455057241276232. DOI: https://doi.org/10.1177/17455057241276232
Garg S, Mishra AK, Singh KR, el at. Sexual health in pre-menopausal breast cancer survivors. Indian J Surg Oncol. 2024;15(3):601-8. doi: https://doi.org/10.1007/s13193-024-01957-3 DOI: https://doi.org/10.1007/s13193-024-01957-3
Roy N, Downes MH, Ibelli T, et al. The psychological impacts of post-mastectomy breast reconstruction: a systematic review. annals of breast surgery: an open access journal to bridge breast surgeons across the world. 2023;8:19. doi: https://doi.org/10.21037/abs-23-33 DOI: https://doi.org/10.21037/abs-23-33
Albers LF, Palacios LAG, Pelger RCM, et al. Can the provision of sexual healthcare for oncology patients be improved? A literature review of educational interventions for healthcare professionals. J Cancer Surviv. 2020;14(6):858-66. DOI: https://doi.org/10.1007/s11764-020-00898-4
von Hippel C, Dibble KE, Rosenberg SM, et al. Taking their wellbeing into their own hands: Self-educated and peer-recommended techniques used by women with breast cancer to improve sexual functioning during treatment and in survivorship. PLoS One. 2023;18(11):e0293298. DOI: https://doi.org/10.1371/journal.pone.0293298
Engel GL. The need for a new medical model: a challenge for biomedicine. Science. 1977;196(4286):129-36. DOI: https://doi.org/10.1126/science.847460
Adler RH. Engel’s biopsychosocial model is still relevant today. J Psychosom Res. 2009;67(6):607-11. doi: https://doi.org/10.1016/j.jpsychores.2009.08.008 DOI: https://doi.org/10.1016/j.jpsychores.2009.08.008
Garcia-Toro M, Aguirre I. Biopsychosocial model in depression revisited. Med Hypoth. 2007;68(3):683-91. doi: https://doi.org/10.1016/j.mehy.2006.02.049 DOI: https://doi.org/10.1016/j.mehy.2006.02.049
Gómez-Juanes R, Roldán-Espínola L, García-Toro M. Depression as reversible biopsychosocial break up after schismogenesis. Med Hypoth. 2024;187:111358. doi: https://doi.org/10.1016/j.mehy.2024.111358 DOI: https://doi.org/10.1016/j.mehy.2024.111358
Linnanen C, Hemberg J, Bjerga GH, et al. Possibilities and limitations in person-centred cancer care: a qualitative study. Scandinavian J Caring Scienc. 2025;39(1):e70002. doi: https://doi.org/10.1111/scs.70002 DOI: https://doi.org/10.1111/scs.70002
Zuzelo PR. Metastatic breast cancer as a chronic condition: holistic care considerations. Holistic Nurs Pract. 2019;33(2):125. doi: https://doi.org/10.1097/HNP.0000000000000316 DOI: https://doi.org/10.1097/HNP.0000000000000316
Makivić I, Kersnik J, Klemenc-Ketiš Z. The role of the psychosocial dimension in the improvement of quality of care: a systematic review. Zdr Varst. 2016;55(1):86-95. doi: https://doi.org/10.1515/sjph-2016-0004 DOI: https://doi.org/10.1515/sjph-2016-0004
Byeon H. Holistic approaches to mitigating psychological distress in gynecological cancer patients. World J Psychiatry. 2024;14(11):1766-71. doi http://dx.doi.org/10.5498/wjp.v14.i11.1766 DOI: https://doi.org/10.5498/wjp.v14.i11.1766
Giribone S, Franscini M, Manfredi V, et al. La presa in carico psicologica del paziente oncologico nel percorso diagnostico terapeutico assistenziale: l’esperienza della AOU di Alessandria. Work Paper Public Hl. 2024;12(1):10050. doi: https://doi.org/10.4081/wpph.2024.10050 DOI: https://doi.org/10.4081/wpph.2024.10050
Alberton CL, Andrade LS, Xavier BEB, et al. Land- and water-based aerobic exercise program on health-related outcomes in breast cancer survivors (WaterMama): study protocol for a randomized clinical trial. Trials. 2024;25(1):536. DOI: https://doi.org/10.1186/s13063-024-08389-y
Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14(5):377-81. DOI: https://doi.org/10.1249/00005768-198205000-00012
Conselho Nacional de Saúde (BR). Resolução n° 466, de 12 de dezembro de 2012. Aprova as diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos. Diário Oficial da União, Brasília, DF. 2013 jun 13; Seção I:59.
Nakamura C, Kawase M. Effects of short-term existential group therapy for breast cancer patients. BioPsychoSocial Med. 2021;15(1):24. doi: https://doi.org/10.1186/s13030-021-00225-y DOI: https://doi.org/10.1186/s13030-021-00225-y
Tan Y, Qin M, Liao B, et al. Effectiveness of peer support on quality of life and anxiety in breast cancer patients: a systematic review and meta-analysis. Breast Care. 2023;18(1):49-59. doi: https://doi.org/10.1159/000527849 DOI: https://doi.org/10.1159/000527849
Wang Y, Feng W. Cancer-related psychosocial challenges. Gen Psych. 2022;35(5):e100871. doi: https://doi.org/10.1136/gpsych-2022-100871 DOI: https://doi.org/10.1136/gpsych-2022-100871
Suls J, Rothman A. Evolution of the biopsychosocial model: prospects and challenges for health psychology. Healt Psychol. 2004;23(2):119-25. DOI: https://doi.org/10.1037/0278-6133.23.2.119
Blickle P, Schmidt ME, Steindorf K. Pretreatment fatigue in breast cancer patients: comparison with healthy controls and associations with biopsychosocial variables. Cancer Med. 2025;14(1):e70404. doi: https://doi.org/10.1002/cam4.70404 DOI: https://doi.org/10.1002/cam4.70404
Faller H, Schuler M, Richard M, et al. Effects of psycho-oncologic interventions on emotional distress and quality of life in adult patients with cancer: systematic review and meta-analysis. J Clin Oncol. 2013;31(6):782-93. DOI: https://doi.org/10.1200/JCO.2011.40.8922
Galway K, Black A, Cantwell M, et al. Psychosocial interventions to improve quality of life and emotional wellbeing for recently diagnosed cancer patients. Cochrane Database Syst Rev. 2012;11(11):CD007064. doi: https://doi.org/10.1002/14651858.cd007064.pub2 DOI: https://doi.org/10.1002/14651858.CD007064.pub2
Myrhaug HT, Mbalilaki JA, Lie NEK, et al. The effects of multidisciplinary psychosocial interventions on adult cancer patients: a systematic review and meta-analysis. Disabil Rehabil. 2020;42(8):1062-70. DOI: https://doi.org/10.1080/09638288.2018.1515265
Taylor SE, Lichtman RR, Wood JV. Attributions, beliefs about control, and adjustment to breast cancer. J Personal Socl Psychol. 1984;46(3):489-502. doi: https://doi.apa.org/doi/10.1037/0022-3514.46.3.489 DOI: https://doi.org/10.1037//0022-3514.46.3.489
Smedsland SK, Vandraas KF, Bøhn SK, et al. Sexual activity and functioning in long-term breast cancer survivors; exploring associated factors in a nationwide survey. Breast Cancer Res Treat. 2022;193(1):139-49. DOI: https://doi.org/10.1007/s10549-022-06544-0
Vegunta S, Kuhle CL, Vencill JA, et al. Sexual health after a breast cancer diagnosis: addressing a forgotten aspect of survivorship. J Clin Med. 2022;11(22):6723. doi: https://doi.org/10.3390/jcm11226723 DOI: https://doi.org/10.3390/jcm11226723
Haghighi FR, Bokaie M, Sefidkar R, et al. Sexual health counseling improves the sexual satisfaction of breast cancer survivors: a randomized controlled trial. Support Care Cancer. 2024;32(11):768. doi: https://doi.org/10.1007/s00520-024-08957-7 DOI: https://doi.org/10.1007/s00520-024-08957-7
Guedes TSR, Guedes MBOG, Lopes JM, et al. Sexual dysfunction in women with breast cancer of Northeast Brazil: a retrospective longitudinal study. Scientific Reports. 2023;13:20441. doi: https://doi.org/10.1038/s41598-023-47684-7 DOI: https://doi.org/10.1038/s41598-023-47684-7
Jing L, Zhang C, Li W, et al. Incidence and severity of sexual dysfunction among women with breast cancer: a meta-analysis based on female sexual function index. Support Care Cancer. 2019;27(4):1171-80. DOI: https://doi.org/10.1007/s00520-019-04667-7
Deci EL, Ryan RM. The support of autonomy and the control of behavior. J Pers Soc Psychol. 1987;53(6):1024-37. DOI: https://doi.org/10.1037//0022-3514.53.6.1024
Ryan RM, Deci EL. A self-determination theory approach to psychotherapy: The motivational basis for effective change. Canadian Psychol. 2008;49(3):186-93. doi: https://psycnet.apa.org/doi/10.1037/a0012753 DOI: https://doi.org/10.1037/a0012753
Rashwan ZI, Shaheen SR, Rasoul ASAEFAE, et al. Empowering mind-body wellness: effect of bundling seated exercises and psychoeducational rehabilitation using the teach-back approach on fatigue and coping of women postmastectomy. BMC Womens Health. 2024;24(1):443. DOI: https://doi.org/10.1186/s12905-024-03242-5
Younis M, Norsa’adah B, Othman A. Effectiveness of psycho-education intervention programme on coping strategies among jordanian women diagnosed with breast cancer: a randomised controlled trial. Breast Cancer (Dove Med Press). 2021;13:285-97. doi: https://doi.org/10.2147/bctt.s299584 DOI: https://doi.org/10.2147/BCTT.S299584
Bani-Ahmed AA, Al-Baghdadi DM, Hussein RA, et al. Variations in depression and anxiety among jordanian women undergoing mastectomy and reconstruction surgery: impact of familial support. Asian Pac J Cancer Prev. 2024;25(9):3277-82. DOI: https://doi.org/10.31557/APJCP.2024.25.9.3277
Morales-Sánchez L, Luque-Ribelles V, Gil-Olarte P, et al. Enhancing self-esteem and body image of breast cancer women through interventions: a systematic review. Int J Environ Res Public Health. 2021;18(4):1640. doi: https://doi.org/10.3390/ijerph18041640 DOI: https://doi.org/10.3390/ijerph18041640
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