Effects of belly dancing intervention on sexual function and body image in breast cancer patients undergoing hormone therapy - randomized clinical trial

Denig, Luiza Andreatta; Boing, Leonessa; Fretta, Tatiana de Bem; Sperandio, Fabiana Flores; Guimarães, Adriana Coutinho de Azevedo

doi:10.1590/fm.2022.35602

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Original Article • Fisioter. mov. 35 (spe) • 2022 • https://doi.org/10.1590/fm.2022.35602 copy

Effects of belly dancing intervention on sexual function and body image in breast cancer patients undergoing hormone therapy - randomized clinical trial

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction:

Breast cancer is a public health problem because of its high incidence. Its often-mutilating treatment can cause serious problems with regard to body image and sexual function in these women. Belly dancing is a possible option to improve the femininity of these women.

Objective:

The aim of this two-arm randomized study was to determine the effect of practicing belly dancing on sexual function and body image in breast cancer patients undergoing adjuvant hormone therapy in Santa Catarina, Brazil.

Methods:

The study randomized 24 women (60 ± 10.4 years old) diagnosed with breast cancer, 11 in the intervention group (IG) and 13 in the control group (CG). A questionnaire was used to evaluate personal and clinical characteristics, body image (BIBCQ), and sexual function (FSFI).

Results:

On the body image scale, in the domains of body stigma (p = 0.002) and body concerns (p = 0.017), significant intergroup differences were found, with better body image for the IG in the post-intervention period when compared to the CG. In sexual function, no significant differences were found.

Conclusion:

Belly dancing as physical exercise helps improve body image in patients with breast cancer undergoing adjuvant treatment with hormone therapy.

Keywords:
Body image; Breast cancer; Dancing; Sexuality

	Total	IG (n = 11) %	CG (n = 13) %	p-value
BMI classification				0.361
Overweight	68.2	54.5	81.8
Normal weight	31.8	45.5	18.2
Schooling				1.000
Primary education	13.6	9.1	18.2
Secondary education	59.1	63.6	54.5
Higher education	27.3	27.3	27.3
Occupation				0.843
Holding one or more jobs	27.3	18.2	36.4
Retired	54.5	63.6	45.5
Unemployed or homemaker	18.2	18.2	18.2
Marital status				0.080
No partner	59.1	81.8	36.4
With partner	40.9	18.2	63.6
Income				0.522
Upper class (A+B)	9.1	18.2	0.0
Middle class (C)	18.2	18.2	18.2
Lower class (D+E)	72.7	63.6	81.8
Previous treatment				1.000
Yes	95.5	90.9	100
No	4.5	9.1	0.0
Hormone therapy				0.817
Anastrozole	54.5	45.5	63.6
Tamoxifen	36.4	45.5	27.3
Exemestane	9.1	9.1	9.1
Recurrence				1.000
Yes	4.5	9.1	0.0
No	95.5	90.9	100
Lymphedema				0.476
Yes	9.1	18.2	0.0
No	90.9	81.8	100
Lymphedema symptom				0.659
Yes	36.4	45.5	27.3
No	63.6	54.5	72.7
Mastectomy type				1.000
Total	13.6	9.1	18.2
Conservative	77.3	81.8	72.7
Bilateral	9.1	9.1	9.1
Reconstruction				0.012
Immediate	9.1	9.1	9.1
Late	27.3	0.0	54.5
Not performed	63.6	90.9	36.4
Axilla				0.269
Axillary emptying	40.9	36.4	45.5
Lymph node biopsy	45.5	36.4	54.5
Not performed	13.6	27.3	0.0
Urinary incontinence				1.000
Yes	13.6	9.1	18.2
No	86.4	90.9	81.8

	IG (n = 11)				CG (n = 13)
Body image	Pre	Post	p-value intragroup^* * p-value for comparison between the pre- and post-IG and CG periods;	CIS	Pre	Post	p-value intragroup^* * p-value for comparison between the pre- and post-IG and CG periods;	CIS	p-value intergroup^ p-value for comparison between IG and CG in the post-intervention period.
Vulnerability	15.5 ± 8.1	16.6 ± 6.0	0.738^a a T-test for paired samples.	+1.1	17.7 ± 4.8	17.2 ± 7.3	0.826^a a T-test for paired samples.	-0.5	0.833^c c T-test for independent samples. dMann-Whitney U test. Significant value (p < 0.05) highlighted in bold. The lower the score, the better the body image was.
Body stigma	52.6 ± 8.0	22.7 ± 7.0	< 0.001^a a T-test for paired samples.	-29.9	40.5 ± 13.1	39.7 ± 13.8	0.891^a a T-test for paired samples.	-0.8	0.002^c c T-test for independent samples. dMann-Whitney U test. Significant value (p < 0.05) highlighted in bold. The lower the score, the better the body image was.
Concern with body	24.1 ± 3.3	11.2 ± 3.2	< 0.001^a a T-test for paired samples.	-12.9	16.9 ± 5.4	14.7 ± 3.3	0.088^a a T-test for paired samples.	-2.2	0.017^c c T-test for independent samples. dMann-Whitney U test. Significant value (p < 0.05) highlighted in bold. The lower the score, the better the body image was.
Limitation	13.7 ± 4.5	11.0 ± 4.4	0.153^b b Wilcoxon test.	-2.7	11.6 ± 4.5	10.9 ± 4.2	0.723^b b Wilcoxon test.	-0.7	0.815^d
Transparency	8.5 ± 5.0	8.0 ± 3.8	0.797^b b Wilcoxon test.	-0.5	8.3 ± 4.7	8.5 ± 5.6	0.722^b b Wilcoxon test.	+0.2	0.626^d
Concern with arms	6.8 ± 3.5	5.36 ± 2.1	0.303^b b Wilcoxon test.	-1.4	6.2 ± 3.0	5.3 ± 3.4	0.423^b b Wilcoxon test.	-0.9	0.669^d

	IG (n = 11)				CG (n = 13)
Sexual fucntion scales	Pre	Post	p-value intragroup^* * p-value for comparison between the pre- and post-IG and CG periods;	CIS	Pre	Post	p-value intragroup^* * p-value for comparison between the pre- and post-IG and CG periods;	CIS	p-value intergroup^ p-value for comparison between IG and CG in the post-intervention period.
Desire	5.0 ± 1.4	4.5 ± 1.6	0.147^a a T-test for paired samples.	-0.5	4.6 ± 1.1	1.0 ± 1.3	0.089^a a T-test for paired samples.	+3.6	0.673^d
Arousal	1.2 ± 2.0	0.9 ± 1.9	0.752^a a T-test for paired samples.	-0.3	2.6 ± 1.9	2.5 ± 1.8	0.933^a a T-test for paired samples.	-0.1	0.346^d
Lubrication	1.5 ± 2.2	1.2 ± 2.1	0.683^a a T-test for paired samples.	-0.3	2.8 ± 2.0	2.9 ± 1.7	0.324^a a T-test for paired samples.	+0.1	1.000^d
Orgasm	1.3 ± 2.0	1.0 ± 1.9	0.674^a a T-test for paired samples.	-0.3	2.8 ± 1.9	2.6 ± 1.5	0.723^a a T-test for paired samples.	-0.2	0.325^d
Satisfaction	1.6 ± 1.6	2.1 ± 1.4	0.396^b b Wilcoxon test.	+0.5	2.4 ± 1.2	1.8 ± 1.2	0.144^b b Wilcoxon test.	-0.6	0.720^c c T-test for independent samples. dMann-Whitney U test. The lower the score, the worse the sexual function.
Desconforto	1.6 ± 2.2	1.3 ± 2.4	0.753^a a T-test for paired samples.	-0.3	3.7 ± 2.4	3.9 ± 2.4	0.623^a a T-test for paired samples.	+0.2	0.931^d
Total score	12.6 ± 9.4	11.3 ± 9.4	0.753^a a T-test for paired samples.	-1.3	19.3 ± 8.8	18.4 ± 7.3	0.715^a a T-test for paired samples.	-0.8	0.074^d

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[1] *Correspondence: luiza.andenig@gmail.com