We aimed to evaluate whether age-matched women with and without early-stage breast cancer differentially experience sexual problems over time and whether changes in patients’ problems differ by surgery type.

We conducted four interviews (4–6 weeks, 6 months, 1 year and 2 years) after surgery (patients) or a negative/benign screening mammogram (controls). Mixed-effects models with repeated ordinal measurements tested effects of time and diagnostic group (stages 0, I, IIA vs. controls) and, for patients, effects of time and type of surgery (mastectomy vs. lumpectomy), on a newly developed 9-item sexual-problems measure. Two-sided P-values < 0.05 were considered significant.

Using data from 1033 women (17.3% stage 0, 33.4% stage I/IIA, 49.3% controls; mean age 57.1; 23.1% non-white; 64.7% married), two factors measuring problems with sexual attractiveness and sexual interest/enjoyment emerged in exploratory factor analysis (alpha ≥ .74 for each subscale and the 9-item measure). Patients and controls reported few sexual problems on average, but compared with baseline, controls were more likely to report sexual problems on the 9-item measure over time, and stage I patients were less likely to report problems with sexual attractiveness over time (each P < 0.05). Patients with mastectomy (35.7%) were 2.7 times more likely to report sexual problems on the 9-item measure at 2-year follow-up compared with baseline (P = 0.0339).

Patients and controls experienced few sexual problems over time and, in fact, controls were more likely to report sexual problems at subsequent interviews, whereas patients did not.