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“My choice”: breast cancer patients recollect doctors fertility preservation recommendations

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Abstract

Purpose

The increasing rates of early-onset breast cancer (BC) and of woman survival render fertility preservation (FP) a pressing issue. We probe women’s experiences of FP counseling and decision making, aiming to identify emergent counseling patterns.

Methods

Semi-structured interviews were conducted with 16 women, who had been diagnosed with BC at the ages of 24–38, 1 to 5 years prior to the interview. BC survivors were recruited through posts in online fora, consented to participate, and were invited to tell their FP stories. The transcribed interviews were analyzed thematically, using the phenomenological paradigm.

Findings

Doctors’ FP recommendations belong into three categories: (a) direct clinical rationale—grounding recommendations in the woman’s clinical condition by direct reference to tumor characteristics and prognosis, (b) indirect clinical rationale—reference to the woman’s clinical condition by outlining a pressing time-frame, and (c) sociodemographic rationale—focus on the woman’s family status. Women’s responses revealed primarily detachment and compliance alongside initiative and proactivism.

Conclusion and implications for cancer survivors

Beyond its contribution to women’s future ability to conceive, FP may constitute an arena of personal autonomy and a coping resource for young BC patients. Raising awareness to this significance may sensitize healthcare providers to the role that FP may play in the moment of cancer diagnosis in adding, alongside sickness and prognosis, a focus on family future planning. As such, FP may affect women’s quality of life and even survival.

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Acknowledgements

We are grateful to the women who participated in the interviews for their efforts and for devoting their time and willingness to share their experience.

Author information

Authors and Affiliations

  1. The Cheryl Spencer Department of Nursing, University of Haifa, Haifa, Israel

    Efrat Dagan, Suzi Modiano-Gattegno & Daphna Birenbaum-Carmeli

Authors
  1. Efrat Dagan
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  2. Suzi Modiano-Gattegno
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  3. Daphna Birenbaum-Carmeli
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Corresponding author

Correspondence to Efrat Dagan.

Ethics declarations

All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the ethics committee of the University of Haifa.

Conflict of interest

The authors declare they have no conflict of interest.

Funding

This study was funded by the Cheryl Spencer Department of Nursing, University of Haifa Internal Grant, and the University of Haifa research authority internal grant (grant numbers are not available).

Informed consent

Informed consent was obtained from all individual participants included in the study. All the personal identifiers have been disguised so the patients described are not identifiable and cannot be identified through the details of the story.

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Dagan, E., Modiano-Gattegno, S. & Birenbaum-Carmeli, D. “My choice”: breast cancer patients recollect doctors fertility preservation recommendations. Support Care Cancer 25, 2421–2428 (2017). https://doi.org/10.1007/s00520-017-3648-1

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  • DOI: https://doi.org/10.1007/s00520-017-3648-1

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