Attitudes of young patients with breast cancer toward fertility loss related to adjuvant systemic therapies. EORTC study 10002 BIG 3‐98

Senkus, Elżbieta; Gómez, Henry L.; Dirix, Luc; Jérusalem, Guy; Murray, Elizabeth; Tienhoven, Geertjan van; Westenberg, A. Helen; Bottomley, Andrew; Rapion, Jérôme; Bogaerts, Jan; Leo, Angelo Di; Nešković-Konstantinović, Z.

doi:10.1002/pon.3384

Cited by 61 publications

(80 citation statements)

References 28 publications

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“…Among a substantial number of younger women with breast cancer, the likelihood of infertility after chemotherapy treatment, and/or the delay in potential attempts at pregnancy due to 5 years of tamoxifen therapy is a signifi cant concern (Senkus et al 2014 ;Partridge et al 2004 ). Young women's attitudes are most infl uenced by whether or not they have already had children, as well as their desire to have future children.…”

Section: Fertility Preservation: Practice and Researchmentioning

confidence: 99%

Symptoms: Menopause, Infertility, and Sexual Health

Barton

Ganz

2015

Improving Outcomes for Breast Cancer Survivors

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By 2022, the number of survivors is expected to grow to nearly 18 million. Therefore, addressing acute and chronic negative sequelae of a cancer diagnosis and its treatments becomes a health imperative. For women with a history of breast cancer, one of the common goals of treatment and prevention of recurrence is to reduce circulating concentrations of estradiol, especially in women with hormone receptor positive breast cancer. Hormone deprivation after a diagnosis of breast cancer impacts physiological targets other than in the breast tissue and can result in unwanted side effects, all of which can negatively impact quality of life and function and cause distress. Symptoms that are most strongly linked by evidence to hormone changes after cancer diagnosis and treatment include hot flashes, night sweats, sleep changes, fatigue, mood changes, and diminishing sexual function, including vaginal atrophy (decreased arousal, dryness and dyspareunia), infertility, decreased desire and negative self-image. Weight gain and resulting body image changes are often concomitants of the abrupt onset of treatment-induced menopause. The purpose of this chapter is to briefly review what is known about the advent of premature menopause in women treated for breast cancer, menopausal symptoms that are exacerbated by endocrine treatments for breast cancer, and the associated concerns of hot flashes and related menopausal symptoms, sexual health and fertility issues. We will discuss limitations in the current research and propose strategies that address current limitations in order to move the science forward.

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Section: Fertility Preservation: Practice and Researchmentioning

confidence: 99%

Symptoms: Menopause, Infertility, and Sexual Health

Barton

Ganz

2015

Improving Outcomes for Breast Cancer Survivors

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“…In addition, few data are reported related to cognitive impairment associated with the use of hormonal and chemotherapy treatment, which can be particularly problematic for the continuation of professional and family-related plans of young women. A European Organization for Research and Treatment of Cancer study about fertility attitudes in young BC women, which included 12% of patients from South America (Peru and Chile), showed that Latin American patients required an increase in the chance of being cured to accept chemotherapy with potential fertility loss and were less likely to accept higher infertility rates than women from the Middle East and Western and Eastern Europe [47].…”

Section: Bc In Young Women: Special Considerationsmentioning

confidence: 99%

Breast Cancer in Young Women in Latin America: An Unmet, Growing Burden

et al. 2013

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Background. Breast cancer (BC) is the leading cause of malignancy-related deaths among women aged Յ45 years. There are unexplored and uncertain issues for BC in this particular group in Latin America. The aim of this study is to evaluate BC incidence and mortality among young women and related clinicopathological and survivorship aspects in this region. Materials and Methods. Data were obtained from Globocan 2008 and the International Agency for Research on Cancer's Cancer Incidence in Five Continents series plus databases. We requested collaborationfromthe12differentnationalcancerin-stitutes in Latin America through SLACOM, the Latin American andCaribbeanSocietyofMedicalOncology,andconductedasystematic literature review to obtain local data regarding the prevalence of BC among young women and their characteristics, outcomes, and survivorship-related issues. Results. BC incidence and mortality proportions for Latin American women aged Ͻ44 years were higher when compared with those of developed countries (20% vs. 12% and 14% vs. 7%, respectively). We found only a few Latin American series addressing this topic, and prevalence varied between 8% and 14%. Stage II and III disease, high histological grade, and triple-negative and HER2 BC were features frequently observed among young Latin American BC patients. Conclusion. The rising incidence and mortality of BC in young Latin American women is a call to action in the region. It is necessary to monitor the epidemiological and clinical data through reliable cancer registries and to consider the implementation of protocols for education of patients and health professionals. This unmet, growing burden must be considered as a top priority of the national programs in the fight against BC, and models of specialized units should be implemented for this particular group of patients to provide better care for this emergent challenge. The Oncologist 2013;18: 1285-1297 Implications for Practice: This review illustrates that breast cancer (BC) among Latin American women is a growing burden throughout the region. The increased proportion of BC cases in young women is important because their diagnoses and tumor behavior are usually more aggressive than in their older counterparts. The findings of this study reveal that there is scarce information regarding this matter in Latin American countries, especially concerning the particular effects and complications that this group of women face during and after treatment. Also, there are no specific clinical or educational programs that focus on this population. A call to action from health policy planners, medical providers, researchers, BC patients, families, and the community in general is deserved for better care of this emergent challenge.

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“…The majority of patients with a current desire to have children decided against a pregnancy because they were afraid of cancer-related effects, such as shortened life expectancy or a negative impact of a pregnancy on BC prognosis. In the study by Ruddy et al [20] analyzing 600 women with BC, 9% of those with maternal desire did not plan a pregnancy because they were afraid of cancer recurrence, while the BIG 3-98 study reported that 40% of women did not fulfill their desire to have children due to this anxiety [21]. In our cohort, only 21.7% of those patients with a desire for motherhood decided to have more children after BC diagnosis.…”

Section: Reproductive Concernsmentioning

confidence: 58%

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

Burgmann¹,

Hermelink²,

Farr

et al. 2018

Breast Care

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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.

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Attitudes of young patients with breast cancer toward fertility loss related to adjuvant systemic therapies. EORTC study 10002 BIG 3‐98

Abstract: For the majority of young patients with breast cancer, cure remains their first priority; for this, they are willing to accept a considerable decrease in future fertility, and only less than 10% will forego chances of cure to preserve fertility.

Cited by 61 publications

References 28 publications

Symptoms: Menopause, Infertility, and Sexual Health

Symptoms: Menopause, Infertility, and Sexual Health

Breast Cancer in Young Women in Latin America: An Unmet, Growing Burden

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

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