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年轻乳腺癌患者的生育力保存

Fertility Preservation for the Young Breast Cancer Patient.

作者信息

Goldfarb Shari B, Kamer Sabrina A, Oppong Bridget A, Eaton Anne, Patil Sujata, Junqueira Manuela J, Olcese Cristina, Kelvin Joanne F, Gemignani Mary L

机构信息

Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Health Outcomes Research Group, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

出版信息

Ann Surg Oncol. 2016 May;23(5):1530-6. doi: 10.1245/s10434-015-5036-8. Epub 2016 Jan 20.

Abstract

BACKGROUND

The American Society of Clinical Oncology (ASCO) guidelines include incorporation of fertility preservation guidelines in the care of breast oncology patients. This study aimed to examine the baseline knowledge and preferences concerning fertility preservation among women of childbearing age with newly diagnosed breast cancer at the time of their initial visit to Memorial Sloan Kettering Cancer Center (MSKCC).

METHODS

A questionnaire on reproductive history, fertility knowledge, and preservation options was administered to women 18-45 years of age with newly diagnosed breast cancer at MSKCC between May and September 2011.

RESULTS

The inclusion criteria were met by 60 women eligible for analysis who had a median age of 40 years (range 20-45 years). The findings showed that 50 % of the women either desired children in the future or were unsure whether they wanted children, with 9 % reporting that they received information about fertility preservation options before their MSKCC visit. Women who had never been pregnant were more likely than those with prior pregnancies to consider having children in the future (p = 0.001) and to contemplate fertility preservation options both before (p = 0.001) and after (p = 0.0002) cancer treatment.

CONCLUSION

Early referral allows patients to take advantage of fertility preservation options while preventing delay in the initiation of systemic therapy. Referral by the breast surgical oncologist at the time of the initial visit has the potential to increase fertility knowledge because it appears that many women have not yet received fertility information at this early treatment stage.

摘要

背景

美国临床肿瘤学会(ASCO)指南包括将生育力保存指南纳入乳腺癌患者的护理中。本研究旨在调查初诊于纪念斯隆凯特琳癌症中心(MSKCC)的新诊断乳腺癌的育龄女性对生育力保存的基线知识和偏好。

方法

2011年5月至9月期间,对MSKCC新诊断为乳腺癌的18 - 45岁女性进行了关于生殖史、生育知识和保存选项的问卷调查。

结果

60名符合纳入标准的女性纳入分析,她们的中位年龄为40岁(范围20 - 45岁)。结果显示,50%的女性未来想要孩子或不确定是否想要孩子,9%的女性报告在前往MSKCC就诊前收到了关于生育力保存选项的信息。从未怀孕的女性比有过怀孕经历的女性更有可能考虑未来生育(p = 0.001),并且在癌症治疗前(p = 0.001)和治疗后(p = 0.0002)都更有可能考虑生育力保存选项。

结论

早期转诊可使患者利用生育力保存选项,同时防止全身治疗开始延迟。乳腺外科肿瘤学家在初诊时进行转诊有可能增加生育知识,因为似乎许多女性在这个早期治疗阶段尚未收到生育信息。

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