The European Vulvovaginal Epidemiological Survey (EVES). Impact of history of breast cancer on prevalence, symptoms, sexual function and quality of life related to vulvovaginal atrophy

Women with history of breast cancer (HBC) frequently suffer from vulvovaginal atrophy (VVA). European Vulvovaginal Epidemiology Survey (EVES) sub-analysis assesses the impact of HBC on VVA, sexual life and quality of life (QoL) in postmenopausal women. Women with at least one VVA symptom aged 45–75 years were included. EuroQol (EQ-5D-3L) and Day-to-Day Impact of Vaginal Aging (DIVA) questionnaires were filled to investigate QoL. VVA diagnosis was confirmed with objective gynecological examination. Comparison of postmenopausal women with and without HBC, and evaluation of treatment impact on VVA were performed. 1985 postmenopausal women without HBC and 175 with HBC were included. VVA was confirmed in 90.4% of women without HBC and 91.4% of women with HBC. There were no differences in VVA symptoms severity or vulvovaginal discomfort between groups. However, women with HBC who had completed treatment and had surgery 11–20 years previously versus those without HBC presented significantly worse Vaginal Health Index scores, as well as a higher prevalence of VVA objective diagnosis, although their overall symptom severity score was lower. Health status and QoL comparisons were similar. Results support a similar burden in terms of VVA prevalence and symptoms, QoL and sexual function in postmenopausal women with and without HBC.

有乳腺癌病史（History of Breast Cancer, HBC）的女性常罹患外阴阴道萎缩（Vulvovaginal Atrophy, VVA）。欧洲外阴阴道流行病学调查（European Vulvovaginal Epidemiology Survey, EVES）子研究旨在评估乳腺癌病史对绝经后女性外阴阴道萎缩、性生活及生活质量（Quality of Life, QoL）的影响。本研究纳入年龄介于45~75岁、存在至少1项外阴阴道萎缩症状的女性。研究采用欧洲五维健康量表（EuroQol, EQ-5D-3L）与阴道衰老日常影响问卷（Day-to-Day Impact of Vaginal Aging, DIVA）对受试者的生活质量进行评估，并通过客观妇科检查确认外阴阴道萎缩的诊断。研究对比了有无乳腺癌病史的绝经后女性，并评估了治疗对阴道萎缩的干预效果。本研究共纳入1985名无乳腺癌病史的绝经后女性与175名有乳腺癌病史的绝经后女性。其中，无乳腺癌病史的女性中有90.4%经检查确诊外阴阴道萎缩，有乳腺癌病史的女性中该比例为91.4%。两组受试者的外阴阴道萎缩症状严重程度及外阴阴道不适程度均无显著差异。然而，完成治疗且手术史距今11~20年的乳腺癌病史女性，其阴道健康指数（Vaginal Health Index）得分显著低于无乳腺癌病史的女性，且客观确诊外阴阴道萎缩的比例更高，但该群体的整体症状严重程度得分更低。两组的健康状况与生活质量比较结果相似。研究结果表明，绝经后女性无论是否伴有乳腺癌病史，其在外阴阴道萎缩的患病率、症状表现、生活质量及性功能层面所承受的健康负担均无显著差异。