Obstetrics & Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia
Obstetrics & Gynaecology, The Royal Women's Hospital, Parkville, Victoria, Australia.
BMJ Open. 2020 Feb 10;10(2):e033669. doi: 10.1136/bmjopen-2019-033669.
As cancer treatments may impact on fertility, a high priority for young patients with breast cancer is access to evidence-based, personalised information for them and their healthcare providers to guide treatment and fertility-related decisions prior to cancer treatment. Current tools to predict fertility outcomes after breast cancer treatments are imprecise and do not offer individualised prediction. To address the gap, we are developing a novel personalised infertility risk prediction tool (FoRECAsT) for premenopausal patients with breast cancer that considers current reproductive status, planned chemotherapy and adjuvant endocrine therapy to determine likely post-treatment infertility. The aim of this study is to explore the feasibility of implementing this FoRECAsT tool into clinical practice by exploring the barriers and facilitators of its use among patients and healthcare providers.
A cross-sectional exploratory study is being conducted using semistructured in-depth telephone interviews with 15-20 participants each from the following groups: (1) premenopausal patients with breast cancer younger than 40, diagnosed within last 5 years, (2) breast surgeons, (3) breast medical oncologists, (4) breast care nurses (5) fertility specialists and (6) fertility preservation nurses. Patients with breast cancer are being recruited from the joint Breast Service of three affiliated institutions of Victorian Comprehensive Cancer Centre in Melbourne, Australia-Peter MacCallum Cancer Centre, Royal Melbourne Hospital and Royal Women's Hospital, and clinicians are being recruited from across Australia. Interviews are being audio recorded, transcribed verbatim and imported into qualitative data analysis software to facilitate data management and analyses.
The study protocol has been approved by Melbourne Health Human Research Ethics Committee, Australia (HREC number: 2017.163). Confidentiality and privacy are maintained at every stage of the study. Findings will be disseminated through peer-reviewed scholarly and scientific journals, national and international conference presentations, social media, broadcast media, print media, internet and various community/stakeholder engagement activities.
由于癌症治疗可能会影响生育能力,因此对于患有乳腺癌的年轻患者来说,首要任务是获取基于证据的个性化信息,以便在癌症治疗前为他们及其医疗保健提供者提供治疗和与生育相关的决策指导。目前预测乳腺癌治疗后生育结局的工具并不精确,也无法提供个体化预测。为了解决这一差距,我们正在为患有乳腺癌的绝经前患者开发一种新的个性化不孕风险预测工具(FoRECAsT),该工具考虑了当前的生殖状态、计划化疗和辅助内分泌治疗,以确定治疗后可能出现的不孕。本研究的目的是通过探索患者和医疗保健提供者使用该 FoRECAsT 工具的障碍和促进因素,来研究将其纳入临床实践的可行性。
正在进行一项横断面探索性研究,使用半结构式深入电话访谈,每个组访谈 15-20 名参与者:(1)40 岁以下、5 年内确诊的患有乳腺癌的绝经前患者,(2)乳腺外科医生,(3)乳腺肿瘤内科医生,(4)乳腺护理护士,(5)生育专家和(6)生育保护护士。乳腺癌患者是从澳大利亚墨尔本维多利亚综合癌症中心的三个附属机构的联合乳腺科招募的-彼得·麦卡勒姆癌症中心、皇家墨尔本医院和皇家妇女医院,临床医生是从澳大利亚各地招募的。访谈将被录音、逐字转录并导入定性数据分析软件,以方便数据管理和分析。
该研究方案已获得澳大利亚墨尔本健康人类研究伦理委员会的批准(HREC 编号:2017.163)。在研究的每一个阶段都保持着保密性和隐私性。研究结果将通过同行评审的学术和科学期刊、国家和国际会议报告、社交媒体、广播媒体、印刷媒体、互联网和各种社区/利益相关者参与活动进行传播。