North Middlesex Hospital NHS Trust, Sterling Way, London, UK.
Oncologist. 2012;17(7):910-6. doi: 10.1634/theoncologist.2012-0064. Epub 2012 Jun 15.
Fertility preservation is an important survivorship issue for women treated for breast cancer. The aim of this work was to examine the referral practices of health care professionals who treat women with breast cancer in the United Kingdom, and to investigate their understanding and knowledge of the fertility preservation options available.
An invitation to participate in a confidential, online questionnaire was e-mailed to surgeons, oncologists, and clinical nurse specialists who manage patients with breast cancer in the United Kingdom.
n = 306 respondents. Factors which influenced whether fertility preservation options were discussed with a patient included the following: patient's age (78%), final tumor/nodes/metastasis status (37.9%); concern that fertility preservation would delay chemotherapy (37.3%); whether the patient had children (33.5%) or a partner (24.7%); estrogen receptor expression (22.6%), lack of knowledge regarding the available options (20.9%); and concern that fertility preservation would compromise the success of cancer treatment (19.8%). Twenty-seven percent did not know whether fertility preservation was available for their patients on the National Health Service. Nearly half (49.4%) of respondents said that gonadotropin-releasing hormone agonists were used for fertility preservation outside the setting of a clinical trial. Knowledge regarding the available options varied according to different members of the multidisciplinary team, with consultant oncologists better informed than consultant surgeons or clinical nurse specialists (p < .05).
Many health care professionals have incomplete knowledge regarding the local arrangements for fertility preservation for patients with breast cancer. This may result in patients receiving inadequate or conflicting information regarding fertility preservation.
生育力保存是乳腺癌治疗女性患者的一个重要生存问题。本研究旨在调查英国乳腺癌治疗医护人员的转介实践,并探讨他们对现有生育力保存选择的理解和认识。
向在英国管理乳腺癌患者的外科医生、肿瘤学家和临床护士专家发送了参加机密在线问卷调查的邀请。
共 306 名受访者。影响与患者讨论生育力保存选择的因素包括:患者年龄(78%)、最终肿瘤/淋巴结/转移状态(37.9%);担心生育力保存会延迟化疗(37.3%);患者是否有孩子(33.5%)或伴侣(24.7%);雌激素受体表达(22.6%)、缺乏对现有选择的了解(20.9%);以及担心生育力保存会影响癌症治疗的成功(19.8%)。27%的人不知道国家卫生服务系统是否为他们的患者提供生育力保存。近一半(49.4%)的受访者表示,促性腺激素释放激素激动剂在临床试验之外用于生育力保存。不同的多学科团队成员对现有选择的了解程度不同,顾问肿瘤学家的信息比顾问外科医生或临床护士专家更丰富(p<.05)。
许多医护人员对乳腺癌患者生育力保存的当地安排知之甚少。这可能导致患者接受的生育力保存信息不足或相互矛盾。