Thewes B, Meiser B, Taylor A, Phillips K A, Pendlebury S, Capp A, Dalley D, Goldstein D, Baber R, Friedlander M L
Department of Medical Oncology, Prince of Wales Hospital, Randwick, New South Wales 2031, Australia.
J Clin Oncol. 2005 Aug 1;23(22):5155-65. doi: 10.1200/JCO.2005.07.773.
The use of chemotherapy and endocrine therapies in the treatment of premenopausal women carries with it reproductive and gynecologic implications that young women may find distressing and discordant with plans for childbearing. This multicenter study aimed to investigate fertility- and menopause-related information needs among young women with a diagnosis of early-stage breast cancer.
Two hundred twenty-eight women with a diagnosis of early-stage breast cancer who were aged 40 years or younger at diagnosis and who were 6 to 60 months after diagnosis were entered onto the trial. Participants completed a mailed self-report questionnaire that included a purposely designed fertility- and menopause-related information needs survey and standardized measures of distress, anxiety, quality of life, menopausal symptoms, and information-seeking style.
Seventy-one percent of participants discussed fertility-related issues with a health professional as part of their breast cancer treatment, and 86% discussed menopause-related issues. Consultation with a fertility or menopause specialist was the most preferred method of obtaining this information. Receiving fertility-related information was rated as being significantly more important than receiving menopause-related information at time of diagnosis (P < .001) and at treatment decision making (P = .058). Receiving menopause-related information was rated as being significantly more important than receiving fertility-related information during adjuvant treatment (P < .05), at completion of adjuvant treatment (P < .001), and during follow-up (P < .001). Common questions, sources of information, and correlates of perceived importance were identified.
The results of this study suggest that younger women have unmet needs for fertility- and menopause-related information and provide preliminary empirical data to guide the development of better fertility- and menopause-related patient education materials for younger women with a diagnosis of early breast cancer.
对绝经前女性进行化疗和内分泌治疗会带来生殖和妇科方面的影响,年轻女性可能会觉得这些影响令人苦恼,且与生育计划不一致。这项多中心研究旨在调查确诊为早期乳腺癌的年轻女性对生育和绝经相关信息的需求。
228名确诊为早期乳腺癌且确诊时年龄在40岁及以下、确诊后6至60个月的女性进入该试验。参与者完成了一份邮寄的自我报告问卷,其中包括专门设计的生育和绝经相关信息需求调查,以及痛苦、焦虑、生活质量、绝经症状和信息寻求方式的标准化测量。
71%的参与者在乳腺癌治疗过程中与医疗专业人员讨论了生育相关问题,86%的参与者讨论了绝经相关问题。咨询生育或绝经专家是获取此类信息的最首选方法。在确诊时(P < .001)和治疗决策时(P = .058),获取生育相关信息被评为比获取绝经相关信息重要得多。在辅助治疗期间(P < .05)、辅助治疗结束时(P < .001)和随访期间(P < .001),获取绝经相关信息被评为比获取生育相关信息重要得多。确定了常见问题、信息来源以及感知重要性的相关因素。
本研究结果表明,年轻女性对生育和绝经相关信息有未满足的需求,并提供了初步实证数据,以指导为确诊早期乳腺癌的年轻女性开发更好的生育和绝经相关患者教育材料。