Knowledge, attitudes and practice of physicians towards fertility and pregnancy-related issues in youngBRCA-mutated breast cancer patients.

Abstract

RESEARCH QUESTION:

This study explored the knowledge, attitudes and practice of physicians towards fertility and pregnancy-related issues in young BRCA-mutated breast cancer patients.

DESIGN:

Physicians attending two international breast cancer conferences completed a 26-item questionnaire exploring fertility preservation, pregnancy during (BCP) or after breast cancer. A statistical comparison was carried out of the responses exploring the same issues in young breast cancer patients overall or specifically in those with BRCA mutations.

RESULTS:

The survey was completed by 273 physicians. Ovarian tissue cryopreservation (33% versus 40%; P = 0.009) and gonadotrophin-releasing hormone analogues during chemotherapy (74% versus 81%; P = 0.001) were less commonly suggested in BRCA-mutated patients than in the overall breast cancer population. 42% of respondents agreed or were neutral on the statement that ovarian stimulation should not be considered safe in BRCA-mutated breast cancer patients. 45% and 30% agreed or were neutral on the statement that pregnancy in breast cancer survivors may increase the risk of recurrence in BRCA-mutated patients or in the overall breast cancer population, respectively (P < 0.001). 15% and 3% disagreed that transplanting the cryopreserved ovarian tissue can be considered safe in BRCA-mutated patients or in the overall breast cancer population, respectively (P < 0.001). 33.3% were against the addition of platinum agents as neoadjuvant chemotherapy in BRCA-mutated patients with BCP.

CONCLUSIONS:

Several misconceptions on fertility preservation and pregnancy-related issues in breast cancer patients persist even among physicians directly involved in breast cancer care. Focused research efforts to address these issues in BRCA-mutated breast cancer patients and education to improve physicians' knowledge and adherence to available guidelines are urgently needed.

• Authors: Matteo Lambertini, Massimo Di Maio, Francesca Poggio, Olivia Pagani, Giuseppe Curigliano, Lucia Del Mastro, Shani Paluch-Shimon, Sibylle Loibl, Ann H Partridge, Hatem A Azim Jr, Fedro A Peccatori, Isabelle Demeestere
• Journal: Reproductive biomedicine online (Reprod Biomed Online) Vol. 38 Issue 5 Pg. 835-844 (May 2019) ISSN: 1472-6491 [Electronic] Netherlands
• PMID: 30914152 (Publication Type: Journal Article)
• Copyright: Copyright © 2019 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Topics

• Adult
• Breast Neoplasms
• Female
• Fertility
• Fertility Preservation
• Health Knowledge, Attitudes, Practice
• Humans
• Male
• Middle Aged
• Physicians (psychology, statistics & numerical data)
• Pregnancy
• Pregnancy Complications, Neoplastic
• Surveys and Questionnaires