A pilot study to examine patient awareness and provider discussion of the impact of cancer treatment on fertility in a registry-based sample of African American women with breast cancer

Abstract

Purpose Fertility is a concern for many cancer patients diagnosed during their reproductive years. Although African American women are more likely to be diagnosed with early breast cancer (i.e., ≤age 40), little is known about patient awareness of or provider discussion related to fertility in this group. We examined African American women’s awareness of the possible impact of cancer treatment on fertility. Methods In a cross-sectional survey of African American women with early-onset breast cancer, demographic and clinical variables were compared with patient awareness and physician discussion of potential fertility loss. Results For women in our sample (N=48), 45.8% reported being aware of the potential impact of cancer treatment on fertility, and 56.3% reported that their providers discussed fertility with them. Bivariate analyses demonstrated that awareness was significantly higher in women diagnosed at age ≤45 (p<0.05), who were nulliparous (p<0.01), or who did not have tubal ligation (p<0.001). Provider discussion was more often reported by patients who were diagnosed in stages 2/3 (p<0.05) and had no children (p<0.01). Conclusion Study results suggest potential health disparities in reproductive health among early-onset breast cancer patients and demonstrate missed clinical opportunities to provide information about fertility that may impact long-term quality of life in early-onset African American breast cancer patients.

Psychosocial needs of young breast cancer survivors in Mexico City, Mexico

“…[ 37 ] Second, in the setting of low- and middle-income countries where survival may be less presumed, a survival-first mentality overshadows fertility concerns. [ 38 ] A third factor is patient-physician dynamics. Patient accounts here are consistent with suboptimal rates of fertility discussion by physicians as documented in a prior study in Mexico as well as in the U.S., and globally.…”

Fertility Preservation for the Young Breast Cancer Patient

“…17,27 Among women who considered having children in the future, 89% reported believing cancer treatment might impact their ability to conceive or have a child, in contrast to other studies reporting <50% of women believing cancer would impact their fertility. 20 However, a different study showed that women overestimated their risk of infertility from cancer treatment. 15 …”

“…Factors associated with greater awareness among women were younger age, nulliparity, and tubal ligation history. 20 …”

Which female cancer patients fail to receive fertility counseling before treatment in the state of Georgia?

“…Differences in who receives fertility counseling have been reported by age, race, education, and parity (20–23). Disparities have also been found in which women receive referrals to a fertility specialist to discuss fertility preservation (24, 25).…”