Sexual Health, Quality of Life, and Fertility Counselling in Breast Cancer Survivors Younger than 40 Years

Background: Young women treated for breast cancer may continue to experience sexual and reproductive problems after treatment. These issues are not always addressed in routine follow-up. We evaluated sexual health, quality of life, and fertility-related counselling in breast cancer survivors younger than 40 years. Methods: We performed a single-centre cross-sectional study including 65 women with non-metastatic breast cancer who had completed primary treatment at least 12 months earlier. Patients completed the EORTC QLQ-C30 and SHQ-22 questionnaires and an additional questionnaire on fertility preservation. Results: Overall quality-of-life scores were relatively preserved, although several domains remained affected, especially physical and role functioning, fatigue, and insomnia. Sexual problems were common, particularly low libido, vaginal dryness, treatment-related impairment of sexual life, and limited communication with healthcare professionals. Women receiving endocrine therapy reported poorer physical, emotional, and cognitive functioning, together with a higher symptom burden and more sexual complaints. Thirty-nine patients (60%) reported receiving information on fertility preservation before treatment, but only 11 underwent a fertility preservation procedure. Women who had undergone fertility preservation reported higher sexual activity scores. Conclusions: In this cohort of young breast cancer survivors, sexual difficulties remained frequent more than one year after completion of treatment, even when overall quality-of-life scores appeared relatively preserved. Fertility counselling was also not uniformly reported. These findings suggest that sexual health and reproductive issues should be addressed more consistently during follow-up care, especially in women receiving endocrine therapy.