Physician Perspectives on Fertility Preservation Discussions with Premenopausal Breast Cancer Patients: Results from a Multihospital Health Care System

Background Ten percent of new breast cancer diagnoses occur in premenopausal women, and oncologic therapies may compromise fertility. Thus, fertility preservation discussions (FPDs) and referral to fertility specialists are imperative prior to initiation of therapy. A previous retrospective chart re...

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Bibliographic Details
Published in:	Annals of surgical oncology Vol. 26; no. 10; pp. 3210 - 3215
Main Authors:	Masciello, Maria C., Bartholomew, Alex J., Haslinger, Michelle, Bozzuto, Laura M., Tung, Shawndeep S., Thibodeau, Renee, Tsiapali, Ekaterini V.
Format:	Journal Article
Language:	English
Published:	Cham Springer International Publishing 01-10-2019 Springer Nature B.V
Subjects:	Breast cancer Breast Neoplasms - drug therapy Breast Neoplasms - psychology Breast Oncology Cancer therapies CHEMOTHERAPY Communication Demography DIAGNOSIS Female Fertility Fertility Preservation - psychology Health Knowledge, Attitudes, Practice Humans MAMMARY GLANDS Medical Oncology - statistics & numerical data MEDICAL PERSONNEL Medicine Medicine & Public Health NEOPLASMS Oncology Patient Education as Topic Patients Physicians Physicians - psychology Physicians - statistics & numerical data Practice Patterns, Physicians' - statistics & numerical data Premenopause Preservation RADIOLOGY AND NUCLEAR MEDICINE Referral and Consultation Reproductive technologies REVIEWS SURGERY Surgical Oncology WOMEN
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Summary:	Background Ten percent of new breast cancer diagnoses occur in premenopausal women, and oncologic therapies may compromise fertility. Thus, fertility preservation discussions (FPDs) and referral to fertility specialists are imperative prior to initiation of therapy. A previous retrospective chart review showed 45% FPD rates at our institution. The aim of this study is to investigate physician perspectives and limitations regarding FPD. Methods An electronic survey was distributed to 30 surgical, medical, and radiation oncologists across ten regional hospitals. Questions addressed provider demographics, and barriers to and facilitators of FPD. Results The survey response rate was 63.3%. Only 31.6% of physicians reported “always” documenting FPD. Respondents opined that the physician prescribing systemic therapy was the most appropriate person to provide FPD. Patient age, treatment with chemotherapy, and patient desire for FPD were more likely to increase FPD ( p < 0.0001, p < 0.05, and p < 0.0001, respectively). The majority of physicians (84.2%) expressed intent to increase FPD rates. Conclusions Fertility preservation is an integral aspect of breast cancer care, requiring thorough discussion and clear documentation. This study identified that physicians believe the medical oncologist is the most appropriate person to have FPDs with patients and that empowering patients to bring up fertility concerns may improve rates of FPDs. Education of physicians and patients about fertility preservation techniques is likely to improve FPDs.
ISSN:	1068-9265 1534-4681 1534-4681
DOI:	10.1245/s10434-019-07563-w