Sexuality, Breast Cancer Survivorship, and Script Theory

Introduction: With new diagnostic technologies and treatment modalities available, more people than ever are living as cancer survivors in the USA, a large percentage of whom are breast cancer survivors. These new technologies and treatments have side effects that impact women’s sexual health during treatment and throughout long-term survivorship from the disease. The purpose of this research was to understand the intersection of breast cancer survivorship and sexuality, including expressions and performance of gender, relationships, and sexual behavior in women in the Midwestern region of the USA. Methods: This study used semi-structured interviews, conducted in 2015 and 2016 with 21 Midwestern women at least 6 months post-treatment. Following traditions of narrative and phenomenological qualitative research, the women’s own stories were used to explore the impact that survivorship, diagnosis, and treatment may have on a woman’s sexual self. Results: Overarching themes included the role of care-giving, impact of the loss of breast tissue, and survival from breast cancer. These themes represent sexual scripts used specifically by women breast cancer survivors to understand and navigate their sexuality, including gender perceptions and performances, experiences of sexual pleasure and satisfaction, and their romantic and sexual relationships. Conclusions: New scripts need to be encouraged with survivors and introduced into the social worlds that surround these individuals. Such scripts would include the importance of self-care throughout life and the importance of an individual’s quality of life beyond mere survival. Policy Implications: More and better education needs to be provided to both healthcare providers and patients with regard to sexual side effects. Policies around standard of care must be adapted to go beyond survival.