The majority of women who have to undergo treatment for breast cancer report some form of impairment of their sexual function and/or a deterioration of their sexual experience and satisfaction.and frequent partner problems

The development of an algorithm based on a biopsychosocial model to facilitate addressing and dealing with sexual and relationship problems of breast cancer survivors.

Literature research, Analysis of videotaped consultations and case discussions in the medical sexology unit of the University Hospital Basel to define common steps of the care of patients with mammary carcinoma.

We have developed a 7 step approach: 1.Understand and overcome barriers to patient-physician communication about sexual issues. 2. Establish a descriptive diagnosis of the sexual problem; 3. Explore the conditioning factors. 4. Moderate a Round Table (with the partner) for educating the couple about the diagnosis and defining therapeutic objectives; 5. Elaborate a treatment plan 6. Help in shared decision making about therapeutic interventions; 7. Evaluation.

Physicians trained in these steps reported a significant increase in a) the frequency with which they addressed sexual issues b) their personal feeling of competence c) a increase in the frequency of either therapeutic interventions or referral to a sexologist.

The practical model developed serves the purpose to facilitate communication about sexual issues with breast cancer patients and enables physicians to define a diagnosis in sexual medicine and install appropriate treatment or referral.