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Physician Perspectives on Fertility Preservation Discussions with Premenopausal Breast Cancer Patients: Results from a Multihospital Health Care System

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Ten percent of new breast cancer diagnoses occur in premenopausal women, and oncologic therapies may compromise fertility. Thus, fertility preservation discussions (FPDs) and referral to fertility specialists are imperative prior to initiation of therapy. A previous retrospective chart review showed 45% FPD rates at our institution. The aim of this study is to investigate physician perspectives and limitations regarding FPD.

Methods

An electronic survey was distributed to 30 surgical, medical, and radiation oncologists across ten regional hospitals. Questions addressed provider demographics, and barriers to and facilitators of FPD.

Results

The survey response rate was 63.3%. Only 31.6% of physicians reported “always” documenting FPD. Respondents opined that the physician prescribing systemic therapy was the most appropriate person to provide FPD. Patient age, treatment with chemotherapy, and patient desire for FPD were more likely to increase FPD (p < 0.0001, p < 0.05, and p < 0.0001, respectively). The majority of physicians (84.2%) expressed intent to increase FPD rates.

Conclusions

Fertility preservation is an integral aspect of breast cancer care, requiring thorough discussion and clear documentation. This study identified that physicians believe the medical oncologist is the most appropriate person to have FPDs with patients and that empowering patients to bring up fertility concerns may improve rates of FPDs. Education of physicians and patients about fertility preservation techniques is likely to improve FPDs.

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Authors’ Contribution

M.C.M., A.J.B., and E.V.T. assisted with study design, data interpretation, and article creation. M.H., L.M.B. and S.S.T. assisted with study and survey design. R.T. assisted with article preparation. All authors gave final approval.

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Authors and Affiliations

  1. Georgetown University School of Medicine, Washington, DC, USA

    Maria C. Masciello MS & Alex J. Bartholomew MS

  2. Division of Breast Surgery, Department of Surgery, Medstar Georgetown University Hospital, Washington, DC, USA

    Michelle Haslinger MD, Laura M. Bozzuto MD, Shawndeep S. Tung MD, Renee Thibodeau MD & Ekaterini V. Tsiapali MD, FACS

  3. Department of Surgery, MedStar Georgetown University Hospital, Washington, DC, USA

    Ekaterini V. Tsiapali MD, FACS

Authors
  1. Maria C. Masciello MS
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  2. Alex J. Bartholomew MS
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  3. Michelle Haslinger MD
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  4. Laura M. Bozzuto MD
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  5. Shawndeep S. Tung MD
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  6. Renee Thibodeau MD
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  7. Ekaterini V. Tsiapali MD, FACS
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Corresponding author

Correspondence to Ekaterini V. Tsiapali MD, FACS.

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Masciello, M.C., Bartholomew, A.J., Haslinger, M. et al. Physician Perspectives on Fertility Preservation Discussions with Premenopausal Breast Cancer Patients: Results from a Multihospital Health Care System. Ann Surg Oncol 26, 3210–3215 (2019). https://doi.org/10.1245/s10434-019-07563-w

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  • DOI: https://doi.org/10.1245/s10434-019-07563-w

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