Department of Medical Oncology, The Ottawa Hospital Cancer Centre, Ottawa, Canada.
Department of Medical Oncology, Cancer Centre of Southeastern Ontario at Kingston General Hospital, Kingston, Canada.
J Adolesc Young Adult Oncol. 2019 Oct;8(5):547-553. doi: 10.1089/jayao.2019.0030. Epub 2019 Jun 3.
Fertility is a concern for young women with breast cancer. We explore patient experiences with fertility discussions at diagnosis to identify barriers and preferences to patient-centered delivery of care. A qualitative study was conducted on consecutive, female breast cancer survivors, 39 years of age or younger at diagnosis and within 2 years of diagnosis, who attended routine outpatient follow-up at a large academic teaching center. Interviews lasted 30 minutes and were transcribed verbatim. Thematic analysis was conducted to explore experiences around fertility discussions. Strength of the theme was determined by examining the frequency of a response. Data collection and analysis continued until theoretical saturation was reached. Analysis comprised 50 women with a median age of 34.5 years (range 25-39 years). Thirty-nine women (78%) had completed university education. Thirty-three women (66%) recalled having fertility preservation discussions at diagnosis. The most common themes identified include the following: (i) the requirement for more patient support, (ii) improving information, (iii) integration of patient values, (iv) creating options for patients, (v) financial limitations, and (vi) the need to look beyond the immediate impact. In this contemporary cohort of young adult breast cancer survivors, fertility discussion experiences at diagnosis remain suboptimal. Improved information and a focus on individual patient desires can improve experiences.
生育能力是年轻乳腺癌患者关注的问题。我们探讨了患者在诊断时对生育讨论的体验，以确定障碍和偏好，从而为以患者为中心的护理提供支持。 一项定性研究针对连续的、39 岁或以下且在诊断后 2 年内接受大型学术教学中心常规门诊随访的女性乳腺癌幸存者进行。访谈持续 30 分钟并逐字转录。采用主题分析来探讨生育讨论方面的经验。主题的强度通过检查响应的频率来确定。数据收集和分析持续进行，直到达到理论饱和。 分析包括 50 名中位年龄为 34.5 岁（范围 25-39 岁）的女性。39 名女性（78%）完成了大学教育。33 名女性（66%）回忆在诊断时进行了生育保存讨论。确定的最常见主题包括以下几点：（i）需要更多的患者支持，（ii）改善信息，（iii）整合患者价值观，（iv）为患者创造选择，（v）经济限制，以及（vi）需要超越眼前的影响。 在这个当代年轻成年乳腺癌幸存者队列中，诊断时的生育讨论体验仍然不尽如人意。改进信息并关注个体患者的愿望可以改善体验。
