Sexual intimacy after breast cancer: A systematic review of qualitative studies on women’s and partners’ experiences in dating and romantic relationships

Abstract

Body changes related to breast cancer treatment are associated with body image concerns and sexual and intimacy difficulties that adversely affect quality of life, yet remain frequently unaddressed by healthcare professionals. Although existing reviews have examined these challenges among women with breast cancer, none have synthesised qualitative evidence incorporating partners’ perspectives or spanning different intimate partnerships, including dating and emerging relationships. This systematic review aimed to synthesise qualitative evidence on how breast cancer and its treatment shape sexual intimacy and romantic relationships for women and their partners, including those in dating or newly forming relationships. Following PRISMA guidelines, a systematic search was conducted across PsycINFO, MEDLINE, CINAHL Plus, AMED, Scopus, PubMed, ProQuest, EThOS and Google Scholar. Data were extracted, appraised for methodological quality using the JBI Critical Appraisal Checklist, and narratively synthesised. Twenty-four studies were identified, with methodological quality ranging from moderate to high. Findings highlight physical and psychological factors that inhibit intimacy for women recovering from breast cancer and their partners across dating and long-term relationships and demonstrate how these factors are mediated by body image. Studies of new post-diagnosis relationships emphasised the importance of disclosure in intimacy progression, with men in dating relationships demonstrating supportive and responsive behaviours, while studies of longer-term relationships highlighted gender stereotypes and intimacy renegotiation. Findings from this review underscore the importance of healthcare professionals recognising the sexual and relational consequences of breast cancer for women and their partners. They also highlight the need to develop interventions that account for the nuances of different relationship contexts.