Body Image and Sexual Health Challenges After Breast Cancer

Young women diagnosed with breast cancer experience significant declines in body image, sexual satisfaction, and sexual interest both during and after treatment, according to research from Memorial Sloan Kettering Cancer Center, which was shared at the 2025 American Society of Clinical Oncology Meeting.

Breast cancer treatment can lead to both temporary and permanent changes in appearance, affecting self-perception. Chemotherapy often causes hair loss, which some women manage with wigs, hats, scarves, or by embracing baldness as a symbol of survivorship, according to the American Cancer Society website. Surgery, particularly mastectomy, may result in partial or complete loss of a breast. Women have different options following surgery, including breast reconstruction, use of breast forms or prostheses, or choosing not to replace the breast at all, the website continued.

With this in mind, researchers from Memorial Sloan Kettering Cancer Center launched the Young Women with Breast Cancer Program in 2023, aiming to better understand how breast cancer treatment impacts body image, sexual health, self-esteem, and personal priorities of patients under age 45 face during this time; researchers evaluated 964 patients int total, 328 of whom were six months into treatment.

Understanding the Impact of Chemotherapy Treatment on Body Image and Sexual Health

This research showed that 46% of young women evaluated felt less positive about their bodies following treatment, while 50% reported a decreased appreciation of their body’s uniqueness. Notably, only 13% saw an improvement in body image during this period. These findings highlight the need for ongoing support from oncology social workers, counselors, and peer programs to help women adjust to their changing bodies.

In response to the statement, “I act as though I like my body,” 36% of patients reported a decline, 24% reported improvement, and 40% remained consistent.

Sexuality is another area strongly affected by breast cancer treatment. Chemotherapy and hormone therapy can alter hormone levels, decreasing sexual desire and affecting sexual response. Additionally, surgery can cause loss of sensation in the affected breast, contributing to discomfort or self-consciousness during intimacy, the American Cancer Society website states.

The Memorial Sloan Kettering Cancer Center survey revealed that 34% of young women experienced a decrease in interest in sexual activity, and 55% reported declines in sexual satisfaction, while only 24% experienced increased interest and 16% reported improved satisfaction, researchers reported. Relationships can also be impacted, as partners may not know how to express love physically and emotionally after treatment, according to the American Cancer Society. Research emphasizes that engaging partners in care decisions and treatment planning can help couples navigate challenges together.

Support and Resources for Young Women During and After Breast Cancer

The Young Women with Breast Cancer Program research highlighted that, at diagnosis, young women were most worried about cancer’s impact on friends and family (27%), discussing cancer with loved ones (16%), and financial issues (15%). By six months into treatment, financial concerns became the top priority (21%), followed by the impact on friends and family (19%) and relationships (16%).

Requests for social work support also shifted over time. At baseline, patients prioritized individual therapy (23%), support groups (21%), family support (19%), educational programs (13%), mental health resources (12%), and peer-to-peer programs (12%). Six months into treatment, individual therapy remained the most requested service (28%), followed by support groups (19%), educational programs (14%), mental health resources (14%), peer-to-peer programs (13%), and family support (11%).

Fertility concerns were also common. Among all participants, 57% had children before diagnosis. Twenty-five percent sought information on fertility preservation, 16% were interested but not ready to act, and 18% underwent fertility preservation. Additionally, 26% desired fertility protection but had not yet pursued it.

“Some studies suggest that younger women tend to have more problems adjusting to the stresses of breast cancer and its treatment. It can feel socially isolating. Younger women might also be more affected by issues of sexuality or fertility... and might worry about how the cancer and its treatment might affect this. Others might have already started families and might worry about how family members might be affected,” the American Cancer Society emphasized.

Overall, the findings presented at the 2025 meeting underscore the need for comprehensive, age-specific care for young women with breast cancer. Targeted interventions addressing sexual health, fertility, body image, and mental health can improve overall quality of life, researchers concluded.

References

1. “The impact of breast cancer treatment on young women’s body image and sexual health,” by Dr. Shari Beth Goldfarb, et al. The Journal of Clinical Oncology.
2. “Body Image and Sexuality After Breast Cancer,” by the American Cancer Society. https://www.cancer.org/cancer/types/breast-cancer/living-as-a-breast-cancer-survivor/body-image-and-sexuality-after-breast-cancer.html

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