Alejandra Platas

Background: Young women with breast cancer (YWBC) face medical and psychosocial challenges that are inconsistently addressed by healthcare frameworks. This study evaluated whether a patient navigation (PN) program for YWBC facilitates access to specialty and supportive care through structured patient needs assessments and referrals. Patients and Methods: Within 3 months of diagnosis, ≤40-year-old patients were prospectively enrolled into a PN program in which a navigator systematically administered needs detection surveys and provided referrals to required services at baseline, 3 months (m), and 6 m. Attendance to referrals at baseline and 3 m was assessed at the next timepoint. Results: Among 189 participants, 85% required >2 referrals at any timepoint. At baseline and 3 m, referrals were mostly to nutrition (66% and 46%), support groups (65% and 24%), and psychology (56% and 36%); and at 6 m, to nutrition (32%), sexology (31%), and psychology (19%). From baseline-to-3m, attendance was highest for support groups (99%), genetic cancer risk assessment (88%), and external breast prosthesis providers (82%); from 3 m-to-6m, for support groups (100%), sexology (91%), and external breast prosthesis (86%). Nearly none attended >2 referrals and receiving more referrals was associated with higher absence rates (p<.001). Conclusion: This PN program enabled structured identification of patients’ needs and referral to required services, highlighting the relevance of nutrition, support groups, and psychology needs during early assessments, as well as sexology counseling during later follow-ups. The high absence rates observed suggest that individualized selection of specific referrals prioritizing patients’ needs and preferences at different timepoints in their cancer trajectory could improve attendance while avoiding patient and health-system oversaturation.

Young women with breast cancer (YWBC) face unique challenges that can impact their sexual health. This study aimed to identify factors associated with sexual activity, function, and satisfaction in YWBC up to five years post-diagnosis. We conducted a prospective cohort study of 474 women aged ≤40 years diagnosed with non-metastatic breast cancer in Mexico. Sexual function and satisfaction were assessed using the Female Sexual Function Index and the Sexual Satisfaction Inventory, respectively. Factors associated with sexual health outcomes were examined using mixed-effects models. The prevalence of sexual dysfunction increased from 33.6% at baseline to 52.9% at 4-5 years post-diagnosis. Factors associated with worse sexual function included older age (mean predicted FSFI score -1.35, p = .037), treatment-induced amenorrhea (-2.86, p < .001), depression (-4.11, p < .001), and anxiety (-2.13, p < .001). Lower sexual satisfaction was associated with lower educational attainment (mean predicted SSI score -5.61, p = .002), being single (-6.41, p < .001), treatment induced amenorrhea (-3.76, p = .004), bilateral oophorectomy (-8.21, p = .017), depression (-11.29, p < .001), and anxiety (-7.50, p < .001). Quality of life, body image, and systemic therapy side effects significantly impacted both outcomes. Three distinct trajectories of sexual function were identified: high (62.2%), intermediate (24.3%), and markedly declining (13.5%). Four trajectories of sexual satisfaction were found, ranging from intermediate-to-high (57.3%) to progressively worsening (27.5%). Sexual dysfunction is prevalent and persistent among YWBC. Multiple biological, psychological, and social factors influence sexual health outcomes in this population. These findings highlight the importance of routine screening and tailored interventions to address the sexual health of YWBC throughout survivorship.