Physicians' Attitudes, Knowledge, and Perceived Barriers toward Fertility Preservation in Young Breast Cancer Patients in a Developing Country

Villarreal‐Garza, Cynthia; Martínez-Cannon, Bertha Alejandra; Barragán-Carrillo, Regina; Bargalló-Rocha, Juan Enrique; Platas, Alejandra; Peña-Curiel, Omar; Torres, Juan; Castro-Sánchez, Andrea; Mohar, Alejandro; Rivera, Samuel

doi:10.24875/ric.20000064

Cited by 8 publications

(9 citation statements)

References 20 publications

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“…Studies show that reproductive education plays a positive role in improving disease-related knowledge and relieving reproductive concerns [29] . Doctors with a stronger sense of responsibility are more willing to communicate with patients and provide effective consultation [30] .…”

Section: Discussionmentioning

confidence: 99%

Reproductive experiences of young women after breast cancer diagnosis: A qualitative study

Qiu

Tang

et al. 2022

Preprint

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Background: Breast cancer has the highest incidence rate among malignant tumors in China, with a trend of affecting younger women. The survival rate of young women with breast cancer has improved significantly, but the treatment to which they are subjected has short- and long-term adverse effects such as damage to the ovaries, which may result in infertility. Such consequences, in turn, increase patients’ concerns over future reproduction and childbearing. At present, patients lack easy access to the informative consultations and accurate patient education. Nor do medical staffs continuously assess their overall well-being, engage in mental healthinterventions, or ensure that they have the knowledge necessary to manage their reproductive concerns. This qualitative study aims to explore the reproductive and psychological experiences of young women with breast cancer who have experienced childbirth after their cancer diagnosis.Methods: A descriptive qualitative study with purposive sampling using audio‑recorded fact‑to‑face interviews was conducted. A total of 12 young women with breast cancer who experienced childbirth after cancer diagnosis participated in this study. Data collection was from September, 2021 to January, 2022 and content analysis method was used to analyze the data. Results: Five distinct themes emerged from the analyses:(1) multifaceted reproductive motivation, (2) multiple emotional experiences, (3) multi-dimensional support needs, (4) influencing factors on reproductive decision-making, and (5) outcome experience of reproductive decision-making. Conclusions: The reproductive decision-making process of young women with breast cancer was affected by many factors. Reproductive motivation came from many aspects. Patients had various emotional experiences in the whole reproductive process and face various difficulties in supporting their needs. Therefore, the reproductive needs of young women with breast cancer should be considered during the reproductive decision-making process, and their reproductive willingness should be recognized as dynamically changing. Professional support and peer support should be provided in the reproductive process to build an effective communication channel for reproductive decision-making, improve the decision-making ability, alleviate the negative emotional experience, and promote a smooth process of reproductive experience for young patients.

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Section: Discussionmentioning

confidence: 99%

Reproductive experiences of young women after breast cancer diagnosis: A qualitative study

Qiu

Tang

et al. 2022

Preprint

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“…Strikingly, 24% of physicians wrongly considered pregnancy and 20% GnRHa use during chemotherapy to be detrimental to the prognosis of BC. 41 Such misconceptions and neglect towards interventions aimed at fertility preservation are not restricted to the Latin American region; a report from East Asia also describes a reduced uptake on fertility preservation strategies due to lack of discussions and referrals to fertility specialists. 42 …”

Section: Fertility Counseling and Preservationmentioning

confidence: 99%

“…In fact, high cost is regarded as one of the most significant barriers for fertility preservation. 41 , 43 , 44 Without insurance coverage, access to fertility preservation strategies is only through out-of-pocket spending, and for a large proportion of BC patients in LMICs, these treatments are unaffordable. 39 , 45 This was illustrated in the previously mentioned 2017 Mexican survey, as only 3% of the surveyed patients considered themselves able to afford extra expenses beyond oncologic treatment.…”

Section: Fertility Counseling and Preservationmentioning

confidence: 99%

Young Women with Breast Cancer in Resource-Limited Settings: What We Know and What We Need to Do Better

Martínez-Cannon¹,

Barragán-Carrillo²,

Villarreal‐Garza³

2021

BCTT

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Young women with breast cancer (YWBC) account for a variable proportion of patients diagnosed with breast cancer around the globe, with a higher prevalence in resource-limited settings than in high-income countries. This group represents a unique population that warrants special attention due to specific biological considerations and age-specific supportive care issues. This review aims to explore existing knowledge regarding YWBC’s needs, particularly in resource-restricted settings. To date, scarce information regarding the care of YWBC in resource-constrained countries is available, with most reports describing suboptimal care in terms of survivorship needs. Health care providers should implement actions to improve endocrine treatment adherence, referrals for fertility counseling and preservation, contraceptive use compliance, timely body image and sexual function interventions, comprehensive genetic risk assessments, and early quality of life and psychosocial health interventions. While high costs act as a barrier for optimal care in resource-limited settings, improving patient education represents a promising and cost-effective solution to improve patient care. Future research on developing tailored educational resources for YWBC in resource-limited settings should be considered a priority.

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“…An extensive systematic review showed that6 66%–100% of patients with cancer expressed a need for fertility information, particularly among young, childless patients with reproductive plans. However, due to a lack of fertility knowledge,7 8 low awareness of fertility preservation,9 a severe shortage of fertility-related information support services10 and a vast selection of fertility preservation therapies,11 it appears to be more challenging for young female patients with cancerto make fertility preservation decisions consistent with their preferences and values in the short period between diagnosis and treatment initiation. The 2018 American Society of Clinical Oncology clinical practice guidelines recommend12 that healthcare professionals should discuss the feasibility of preserving fertility with female patients with cancer who wish to preserve their fertility as early as possible prior to treatment in order to provide patients with more options.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness and feasibility of online fertility preservation decision aids for young female patients with cancer: a systematic review protocol

et al. 2023

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IntroductionCancer diagnosis and treatment can impair fertility, and younger female patients with cancer have a particularly strong need for fertility preservation. Fertility preservation decision aids are thought to help patients make proactive and informed treatment decisions. This systematic review aims to assess the effectiveness and feasibility of online fertility preservation decision aids for young female patients with cancer.Methods and analysisPubMed, Web of Science Core Collection, Embase, The Cochrane Central Register of Controlled Trials, PsycINFO and CHINAL, along with three grey literature sources (Google Scholar, ClinicalTrials.gov and WHO International Clinical Trials Registry Platform), will be searched from each database’s establishment to 30 November 2022. Two trained reviewers will independently screen the articles, and the data extraction and methodological quality of eligible randomised controlled trials and quasiexperimental studies will be assessed. A meta-analysis will be performed using Review Manager V.5.4 (Cochrane Collaboration) software, and heterogeneity will be assessed using I² statistics. If a meta-analysis is not possible, a narrative synthesis will be done.Ethics and disseminationSince this systematic review is based on published data, no ethical approval is required. The study’s findings will be disseminated through peer-reviewed publications and conference presentations.PROSPERO registration numberCRD42022363287.

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Physicians' Attitudes, Knowledge, and Perceived Barriers toward Fertility Preservation in Young Breast Cancer Patients in a Developing Country

Abstract: ‡ Villarreal-Garza and Martinez-Cannon are both to be considered first authors as they contributed equally to this manuscript.

Cited by 8 publications

References 20 publications

Reproductive experiences of young women after breast cancer diagnosis: A qualitative study

Reproductive experiences of young women after breast cancer diagnosis: A qualitative study

Young Women with Breast Cancer in Resource-Limited Settings: What We Know and What We Need to Do Better

Effectiveness and feasibility of online fertility preservation decision aids for young female patients with cancer: a systematic review protocol

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