Shimizu Chikako, Kato Tomoyasu, Tamura Nobuko, Bando Hiroko, Asada Yoshimasa, Mizota Yuri, Yamamoto Seiichiro, Fujiwara Yasuhiro
Breast and Medical Oncology Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan,
Int J Clin Oncol. 2015 Feb;20(1):82-9. doi: 10.1007/s10147-014-0676-4. Epub 2014 Feb 22.
Treatment-related infertility is one of the important quality-of-life issues in young breast cancer (YBC) patients. Although existing guidelines recommend supporting fertility preservation (FP) of YBC, the perceptions of reproductive specialists (RS) has not been evaluated. We investigated the perceptions and needs of RS with regard to FP of YBC patients.
A cross-sectional survey was sent to 423 certified RS registered to the Japan Society for Reproductive Medicine to self-evaluate their perceptions and needs regarding FP in YBC patients.
Two hundred RS (47 %) responded to the survey. 99 % responded that RS should be engaged in FP of YBC patients. 88 % responded that they would like to treat YBC patients, while 46 % responded that cancer treatment is more important than childbirth, even when the patient is recurrence-free 5 years after primary treatment. Respondents affiliated to private clinics were more likely to accept both fertilized and unfertilized egg preservation than those affiliated with academic or general hospitals. 70 % responded that they were anxious about treating breast cancer patients: concerns regarding a greater or unknown risk of recurrence (66 %), insufficient knowledge about breast cancer (47 %), and lack of a patient's spouse/partner (24 %) were identified as major barriers in supporting FP for YBC patients.
RS recognize the need for FP in YBC patients and are willing to participate in their care. Affiliation of RS was related to a positive attitude to egg preservation. Various concerns regarding FP among RS indicate the need for evidence that supports the safety of FP, inter-disciplinary communication, and practice guidelines.
与治疗相关的不孕症是年轻乳腺癌(YBC)患者重要的生活质量问题之一。尽管现有指南建议支持YBC患者的生育力保存(FP),但生殖专家(RS)的看法尚未得到评估。我们调查了RS对YBC患者FP的看法和需求。
向日本生殖医学协会注册的423名认证RS发送了一项横断面调查,以自我评估他们对YBC患者FP的看法和需求。
200名RS(47%)回复了调查。99%的人回复说RS应该参与YBC患者的FP。88%的人回复说他们愿意治疗YBC患者,而46%的人回复说即使患者在初次治疗后5年无复发,癌症治疗也比生育更重要。与学术或综合医院附属的RS相比,私人诊所附属的RS更有可能接受受精卵和未受精卵的保存。70%的人回复说他们对治疗乳腺癌患者感到焦虑:对复发风险更高或未知(66%)、对乳腺癌知识不足(47%)以及缺乏患者的配偶/伴侣(24%)被确定为支持YBC患者FP的主要障碍。
RS认识到YBC患者对FP的需求,并愿意参与他们的护理。RS的附属机构与对卵子保存的积极态度有关。RS对FP的各种担忧表明需要支持FP安全性的证据、跨学科交流和实践指南。