Center for Health Technology and Services Research (CINTESIS), Department of Education and Psychology, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal.
Department of Education and Psychology, University of Aveiro, Aveiro, Portugal.
Breast Cancer. 2020 Nov;27(6):1177-1186. doi: 10.1007/s12282-020-01124-w. Epub 2020 Jun 24.
The threat to fertility due to anticancer treatments can be distressing to women who wish to complete their family. The current study assessed the fertility-related concerns, psychological distress and health-related quality of life (HRQoL) of breast cancer survivors in comparison to non-cancer women with infertility history and to healthy controls from the general population.
We surveyed young adult women aged 18 to 40 who wished to have a (or another) biological child. Participants completed self-report measures assessing fertility concerns, anxiety, depression and physical, emotional, role and social functioning. Group differences were assessed using multivariate comparisons as well as univariate tests and discriminant analysis for individual measures.
A total of 136 women were recruited, of whom 43 were breast cancer survivors, 56 non-cancer infertile women and 37 healthy controls. Considering the female cancer survivors as the focus of the analysis, data suggested that these women presented identical concerns to the non-cancer infertile group and higher than the healthy women with regard to fertility potential (p < 0.01). However, women diagnosed with cancer reported worse HRQoL than their counterparts, showing lower scores in physical functioning (p < 0.05) than infertile women and lower role (p < 0.05) and social HRQoL (p < 0.01) than the controls. Anxiety and depressive symptoms did not differ between the three groups.
The results suggest that living with uncertainty about reproductive potential after cancer can be a disruptive experience. Breast cancer survivors and infertile women are at risk of future emotional maladjustments, given the reported level of fertility concern.
抗癌治疗对生育能力的威胁可能会令那些希望组建家庭的女性感到痛苦。本研究评估了乳腺癌幸存者与有不孕史的非癌症女性和一般人群中的健康对照组相比，其与生育相关的担忧、心理困扰和健康相关生活质量（HRQoL）。
我们调查了年龄在 18 至 40 岁之间、希望拥有（或另一个）亲生子女的年轻成年女性。参与者完成了自我报告的生育问题、焦虑、抑郁以及身体、情感、角色和社会功能的评估。使用多元比较以及单变量测试和判别分析来评估组间差异。
共招募了 136 名女性，其中 43 名是乳腺癌幸存者，56 名是非癌症不孕女性，37 名是健康对照组。考虑到女性癌症幸存者是分析的重点，数据表明，这些女性与非癌症不孕组存在相同的生育问题，而且她们对生育潜力的担忧比健康女性更高（p<0.01）。然而，诊断出患有癌症的女性报告的 HRQoL 比她们的对照组差，在身体功能方面的得分较低（p<0.05），比不孕女性的角色（p<0.05）和社会 HRQoL（p<0.01）得分更低。三组之间的焦虑和抑郁症状没有差异。
研究结果表明，在癌症后对生育能力的不确定性可能会带来破坏性的体验。鉴于报告的生育问题水平，乳腺癌幸存者和不孕女性有未来情绪失调的风险。
