Prospective Study of Fertility Concerns and Preservation Strategies in Young Women With Breast Cancer

被引:286
|
作者
Ruddy, Kathryn J. [1 ]
Gelber, Shari I. [1 ]
Tamimi, Rulla M. [2 ]
Ginsburg, Elizabeth S. [2 ]
Schapira, Lidia [3 ]
Come, Steven E. [4 ]
Borges, Virginia F. [5 ]
Meyer, Meghan E. [1 ]
Partridge, Ann H. [1 ]
机构
[1] Dana Farber Canc Inst, Boston, MA 02115 USA
[2] Brigham & Womens Hosp, Boston, MA 02115 USA
[3] Massachusetts Gen Hosp, Boston, MA 02114 USA
[4] Beth Israel Deaconess Med Ctr, Boston, MA 02215 USA
[5] Univ Colorado Denver, Aurora, CO USA
关键词
OVARIAN STIMULATION; AMERICAN-SOCIETY; CHEMOTHERAPY; SURVIVORS; PREMENOPAUSAL; MULTICENTER; LETROZOLE; ESTROGEN; AMENORRHEA; PREGNANCY;
D O I
10.1200/JCO.2013.52.8877
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose Most research regarding fertility in young women with breast cancer has focused on long-term survivors. Little is known about how fertility concerns affect treatment decisions or fertility preservation strategies at the time of initial cancer diagnosis. Patients and Methods As part of an ongoing prospective multicenter cohort study, we surveyed women with newly diagnosed early-stage breast cancer at age 40 years. The baseline survey included sociodemographic, medical, and treatment data as well as a modified Fertility Issues Survey, including fertility concern and preservation items. Univariable and multivariable modeling were used to investigate predictors of greater fertility concern. Results Among the first 620 eligible respondents included in this analysis, median age was 37 years (range, 17 to 40 years); 425 women (68%) discussed fertility issues with their physicians before starting therapy, and 319 (51%) were concerned about becoming infertile after treatment. Because of concerns about fertility, four women (1%) chose not to receive chemotherapy, 12 (2%) chose one chemotherapy regimen over another, six (1%) considered not receiving endocrine therapy, 19 (3%) decided not to receive endocrine therapy, and 71 (11%) considered receiving endocrine therapy for < 5 years; 65 (10%) used fertility preservation strategies. Greater concern about fertility was associated with younger age, nonwhite race, not having children, and receipt of chemotherapy. Conclusion Many young women with newly diagnosed breast cancer have concerns about fertility, and for some, these substantially affect their treatment decisions. Only a minority of women currently pursue available fertility preservation strategies in this setting. J Clin Oncol 32:1151-1156. (C) 2014 by American Society of Clinical Oncology
引用
收藏
页码:1151 / 1156
页数:6
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