scholarly journals Evaluation of Reproductive Concerns and Biographical Impact of Breast Cancer in Young Patients

Breast Care ◽  
2018 ◽  
Vol 13 (2) ◽  
pp. 124-128 ◽  
Author(s):  
Maximiliane Burgmann ◽  
Kerstin Hermelink ◽  
Alex Farr ◽  
Friederike van Meegen ◽  
Annika Heiduschk ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Genetic Testing ◽  
Fertility Preservation ◽  
Young Patients ◽  
Initial Decision ◽  
Time Period ◽  
Partnership Status ◽  
Reproductive Concerns ◽  
Young Breast Cancer ◽  
Testing And Counseling

Background: This study evaluates interventions offered to young breast cancer (BC) patients, including fertility preservation, genetic testing, and counseling for parenthood concerns, and analyzes the effect of BC on biographical issues. Methods: Women who were diagnosed with BC at the age of 18-40 years and who underwent treatment at the Breast Center, Ludwig-Maximilian University (LMU) in Munich between 2006 and 2013, were eligible for this study. Patients received a self-developed questionnaire which covered the following topics: fertility preservation, family planning, genetic testing, parenthood concerns and children's needs, partnership status, and employment situation. Results: Re-evaluating their initial decision on fertility preservation, 76.4% of patients reported satisfaction with their decision. After BC diagnosis, 45.8% reported to have maternal desire, but only 21.7% actually planned to have children. 41.7% of patients missed sufficient counseling regarding parenthood concerns. Analysis of individual employment situations showed that the time period until the return to work was longer in patients who received chemotherapy. The majority of patients (71.6%) did not report changes in their partnership status. Conclusion: Young BC survivors report a lack of communication related to parenthood concerns and future conception, but are satisfied with counseling regarding fertility preservation and genetics.

The importance of fertility preservation in women with early breast cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20663-e20663
Author(s):  
A. Agbarya ◽  
S. Linn
Keyword(s):  
Breast Cancer ◽  
Fertility Preservation ◽  
Young Women ◽  
Large Scale ◽  
Breast Cancer Survivors ◽  
Early Stage ◽  
Young Patients ◽  
Future Research ◽  
Medical Procedure ◽  
Young Breast Cancer

e20663 Background: Young women with breast cancer often seek advice regarding treatment effects on their fertility. The purpose of this study was to gain a better understanding of women's attitudes to fertility and how these concerns affect decision-making. Methods: A survey on fertility issues was developed for young women with a history of early-stage breast cancer. The survey was completed by direct interviews with the patients. Results: Eighty-four eligible respondents completed the survey. Mean age at breast cancer diagnosis was 34.7 years. Fifty-seven percent of the women were Jewish and 43% were Arabic; 71% were married; 75% had more than 12 years of education. Stages at diagnosis were: I - 51%; II - 38%; III - 11%. Seventy-seven percent of the women were within six months of diagnosis and 49% reported substantial concern about becoming infertile with treatment. In multivariate logistic regression, a greater concern about infertility was associated with a wish for children (p=0.0008), number of children less than three (p=0.001), more than 12 years of education (p=0.004), and a moderate or high level of fear of treatment (p=0.004). Seventy-nine percent of patients reported discussing fertility concerns with their doctors, and 14% underwent a medical procedure for fertility preservation. Only five patients stated that infertility concerns influenced their treatment decisions. Conclusions: 1. Fertility after treatment is a major concern for young breast cancer patients undergoing chemotherapy. 2. This statement was not affected by ethnicity. 3. There is a need to communicate with and educate young patients regarding fertility issues and large scale future research directed at preserving fertility for young breast cancer survivors is warranted. No significant financial relationships to disclose.

scholarly journals Fertility preservation and decisional regret in young breast cancer survivors: A longitudinal analysis.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 106-106
Author(s):  
Samantha Rose Dewald ◽  
Loki Natarajan ◽  
Irene Su
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Fertility Preservation ◽  
Repeated Measures ◽  
Breast Cancer Survivors ◽  
Ovarian Function ◽  
Future Fertility ◽  
Young Breast Cancer ◽  
Decisional Regret ◽  
Over Time

106 Background: Fertility is important to many young breast cancer survivors (YBCS), who face difficult decisions on whether to undergo fertility preservation prior to treatment. Because few longitudinal data assessing decisional regret are available, the objectives of this study were to assess longitudinal changes in decisional regret on fertility preservation following breast cancer diagnosis; determine if fertility preservation treatment decisions are related to decreased decisional regret. Methods: From 3 academic breast cancer programs, 169 YBCS younger than age 45 were recruited at diagnosis between 2009 and 2012 and followed prospectively for ovarian function. Participants completed questionnaires on fertility preservation choices and the Decisional Regret Scale (DRS) during study visits every 6 months for up to 5 years. DRS is scored 0 (no regret) to 100 (highest regret). DRS was dichotomized as none versus any decisional regret. Generalized linear models estimated the change in DRS over time and the association between patient characteristics and DRS. Results: Mean age at diagnosis was 38.7 (SD 4.8). Median total follow-up was 176 days (IQR 84 to 1415 days). Enrollment DRS was available for 89 women; 48% reported decisional regret about fertility preservation (median DRS=20). Participants worried about future fertility were more likely to report decisional regret (p=0.009). 31% underwent fertility preservation, but this was not associated with decisional regret (p=0.65). In repeated measures analysis for the entire cohort, no significant change in DRS occurred over this time period (OR 0.8, 95% CI 0.4-1.7). Worry about future fertility remained significantly associated with DRS over time (OR 55.1, 95% CI 7.7-395.1). Conclusions: In a cohort of YBCS, experiencing decisional regret about fertility preservation persists for years after diagnosis. Those worried about future fertility are more likely to experience decisional regret regarding fertility preservation.

O-180 Oocyte vitrification for fertility preservation does not delay the initiation of neoadjuvant chemotherapy for breast cancer

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
I Sellami ◽  
M Grynberg ◽  
A Benoit ◽  
C Sifer ◽  
A Mayeur ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
Fertility Preservation ◽  
Cancer Diagnosis ◽  
Ovarian Tissue ◽  
Young Patients ◽  
Oocyte Retrieval ◽  
Breast Cancer Patients ◽  
Oocyte Vitrification

Abstract Study question Does oocyte vitrification for fertility preservation (FP) delay the initiation of neoadjuvant chemotherapy for breast cancer? Summary answer The indication of neoadjuvant chemotherapy for breast cancer should not be considered as an impediment to urgent oocyte vitrification for FP. What is known already FP is considered as one of the most important issues to address for young breast cancer patients. Cryopreservation of oocytes or embryos may be considered after controlled ovarian hyperstimulation (COH) or in vitro maturation (IVM). Pregnancies have been reported after reutilization of oocytes frozen following both procedures. Although oocyte competence is better after COH, this strategy requires on average 13 days to be achieved. In addition, the safety of ovarian stimulation before tumor removal is currently not formally established. In case of neoadjuvant chemotherapy, the risk-benefit balance of COH is not well known. Study design, size, duration Retrospective cohort study including all breast cancer patients eligible for oocyte vitrification following COH or IVM before initiation of neoadjuvant chemotherapy between January 2016 and December 2020. Participants/materials, setting, methods Inclusion criteria were: female patients with confirmed non metastatic breast cancer, 18 to 40 years of age, with indication of neoadjuvant chemotherapy, who have had oocyte retrieval for FP after COH or IVM +/- cryopreservation of ovarian tissue. Various time-points related to cancer diagnosis, FP or chemotherapy were obtained from medical record review. Main results and the role of chance A total of 198 patients with confirmed breast cancer who had oocyte retrieval following COH (n = 57) or IVM +/- cryopreservation of ovarian tissue (n = 141) for FP prior to neoadjuvant chemotherapy were included. Although women in IVM group were significantly younger as compared to patients who underwent COH (31.7 ± 4.2 vs. 33.3 ± 4.0 years, p = 0.019), ovarian reserve parameters, BMI and cancer stage did not differ between the two groups. Overall, the average time from cancer diagnosis to chemotherapy start was similar between patients having undergone COH or IVM before oocyte vitrification (37.3 ± 13.8 vs. 36.9 ±13.5 days in COH and IVM groups respectively, p=0.857). Limitations, reasons for caution The time from referral to FP consultation may have influenced the type of FP. In addition, the retrospective nature of the present analysis may constitute a limitation. Moreover, the efficiency and security of the different FP strategies used has not been analysed. Wider implications of the findings Oocyte vitrification following COH or IVM was not associated with delayed breast cancer treatment in the neoadjuvant setting, so long as there was a prompt FP referral. Young patients undergoing neoadjuvant chemotherapy should be informed of these findings to avoid unnecessary anxiety due to concern for delays. Trial registration number Not applicable

Fertility preservation in young breast cancer patients: A population-based study.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 90-90
Author(s):  
Diana Nguyen ◽  
Ghader Jamjoum ◽  
Ari N. Meguerditchian
Keyword(s):  
Breast Cancer ◽  
Fertility Preservation ◽  
Service Use ◽  
Estrogen Therapy ◽  
Population Based ◽  
Administrative Claims ◽  
Breast Cancer Patients ◽  
Population Based Study ◽  
Young Breast Cancer ◽  
Universal Health

90 Background: Treatment-related infertility is an important cause of distress in young women with breast cancer (YWBC) that is preventable by fertility preservation (FP) prior to initiating therapy. This study assesses FP service use by YWBC in Quebec (Canada). Methods: Administrative claims for women ≤ 40 diagnosed between 01-04-2012 and 31-03-2018 were identified using Quebec’s universal health services database (RAMQ). Access to and use of FP services were ascertained by identifying claims for a visit with an obstetrician/gynecologist (OB/GYN) ≤ 90 days of diagnosis, followed by claims for ovarian stimulation, ovule harvesting or artificial insemination. Patient, disease and treatment-related predictors were estimated using logistic regression. Results: 1 616 YWBC were treated. Mean age was 36 (SD 4.1), 72.1% had a CCI = 0, 84.5% were urban residents, and 72.2% experienced some form of socioeconomical disadvantages. Stage distribution was: 0.93%, 68.8, and 30.3% for stages 0, 1-2, and 3 respectively. 53.0% had a mastectomy, 40.8% received chemotherapy (CT), 70.7% received radiotherapy, 20.9% initiated anti-estrogen therapy. 387 YWBC consulted an OB/GYN within 90 days of diagnosis and 155 subsequently received FP services. Predictors associated with FP use included: decreased age (OR= 0.82, 95CI = 0.79-0.86), type of surgery (OR = 0.46, CI = 0.22-0.97), social isolation (OR =1.39, 95CI = 0.99-1.96) and receipt of chemotherapy (OR = 1.74, 95CI = 1.10-2.76). Conclusions: Only 23.9% of eligible YWBC in Quebec accessed FP specialists. Of these, 40.1% chose to move forward with FP. These findings raise important questions on how to optimize access to FP expertise. [Table: see text]

Young patients with breast cancer (< 35 years): Single-institution study of 194 patients from India.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11013-e11013
Author(s):  
B. K Mohanti ◽  
Vinod Raina ◽  
Ajay Gogia ◽  
S. V. S Deo ◽  
N. K Shukla
Keyword(s):  
Breast Cancer ◽  
Young Women ◽  
Ductal Carcinoma ◽  
Tumour Size ◽  
Positive Family History ◽  
Young Patients ◽  
Radical Mastectomy ◽  
Histopathological Analysis ◽  
Duration Of Symptoms ◽  
Young Breast Cancer

e11013 Background: Breast cancer in young women ( < 35 years) is uncommon and accounts for 1-2 % of all breast cancer in the West .There is paucity of data on young breast cancer from India. The aim of our study was to assess clinical and pathological parameters and outcome in young breast cancer patients. Methods: Annually we register approximately 350 new cases of breast cancer of whom young patients constitute a small fraction. This analysis was carried out in 194 patients with aged 35 years or less, who were registered in our clinic between 2000-2009, this constituted about 5.5 % of all new cases. Patients records were analysed from computer database using ICD code (C-50) Results: The median age was 31 years (range 21-35). The median duration of symptoms was 11.8 months (range 0.5-40). Breast lump was the commonest (93%) presenting symptom (left >right side). Ninety percent of patients were married and median age at first child birth was 23 years. Positive family history was elicited in 8 patients, and 3 patients presented with synchronous malignancy. The TNM (7th edition) stage distribution was stage I was 3 %, stage II- 20%, stage III- 55%, and stage IV- 22%. The median clinical tumour size was 5.9 cm. Modified Radical mastectomy was the commonest surgical procedure and this was done in 81 % of cases. The histopathological analysis showed 94% had infiltrating ductal carcinoma. Sixty percent of tumours were high grade and 56% had pathological node positive disease. ER/PR status and Her2 Neu status was available in 65% and 50% respectively. Out of these patients ER and her2neu positivity was 40% and 37% respectively. Triple negative breast cancer (TNBC) constituted 31%. A combination of anthracyclines and taxanes were used in the vast majority of patients and herceptin was used only in 5 %. With a median follow up of 30 months, three years event free (EFS) and overall survival (OS) was 50% and 60%. Higher Nodal stage, tumour size (>5 c.m ), negative ER/PR status and visceral metastasis at baseline predicted poor outcome. Conclusions: Young women constituted 5.5% cases with higher proportion of triple negativity, this is higher than the western population reflecting younger age of our population of breast cancer in general with a resultant poorer outcome.

Disparities in pretest genetic counseling among a population-based sample of young breast cancer patients.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 1579-1579
Author(s):  
Sonya Reid-Lawrence ◽  
Tuya Pal ◽  
Ingrid A. Mayer ◽  
Xiao-Ou Shu ◽  
Ann Tezak ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Genetic Counseling ◽  
Genetic Testing ◽  
Cancer Patients ◽  
Hereditary Cancer ◽  
Medical Records ◽  
Population Based ◽  
Racial Groups ◽  
Breast Cancer Patients ◽  
Young Breast Cancer

1579 Background: Per national practice guidelines, pre-test genetic counseling (GC) through a board-certified or credentialed genetics health professional (GHP) is recommended when testing for hereditary cancer. We sought to compare differences in rates of pre-test GC among young breast cancer (BC) patients tested with or without GHP involvement across three racial groups (Black, Hispanic and non-Hispanic white (NHW)). Methods: A population-based sample of Black, Hispanic and NHW women diagnosed with invasive BC ≤ age 50 from 2009 to 2012 were recruited through the Florida State Cancer Registry. Participants were asked to complete a baseline questionnaire and release medical records for verification of clinical information and genetic testing. We compared the rates of pre-test GC across racial groups in women tested with or without GHP involvement using Analysis of Variance. Multivariate logistic regression analysis was also conducted to adjust for potential confounders. Results: Of 1618 participants, 828 had genetic testing based on medical records and/or self-reported on their questionnaire. There were 170 (20.5%) with GHP involvement (either through consultation and/or test ordering) and the remaining 658 women (79.5%) had no documentation of GHP involvement. Among patients tested without GHP involvement, rates of pre-test GC were significantly lower among Black women (34.8%) compared to Hispanics (80%) and NHW (78.7%) (p < 0.001). In contrast, among those with GHP involvement, rates of pre-test GC were similar among Black (89.7%), Hispanic (81.1%) and NHW (84.6%) (p = 0.89). Conclusions: Our results suggest that among young breast cancer patients tested for hereditary cancer without GHP involvement, Blacks were significantly less likely to receive pre-test GC, compared to the other two groups. In contrast, rates of pre-test GC among those with GHP involvement were similar across all groups. These results suggest a disparity in receipt of pre-test GC (which is standard of care per national guidelines) among Blacks tested without GHP involvement. These findings are concerning given the need to offer guideline-adherent care to all patients receiving hereditary cancer testing.

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