Nardin Simone, Arecco Luca, Delucchi Virginia, Blondeaux Eva, Stana Mihaela, de Moura Leite Luciana, Weis Luiza Nardin, Hoang Giang Pham, Daneri Arianna, Bruzzone Francesca, Meacci Arianna, Molinelli Chiara, Razeti Maria Grazia, Perrone Martina, Paluch-Shimon Shani, Partridge Ann H, Cardoso Fatima, Spanic Tanja, Kufel-Grabowska Joanna, Lambertini Matteo
SCDU Oncologia, AOU Maggiore della Carità, Novara, Italy; Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy.
Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy; Université libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), Institut Jules Bordet, Academic Trials Promoting Team (ATPT), Bruxelles, Belgium.
Breast. 2025 Apr 24;82:104479. doi: 10.1016/j.breast.2025.104479.
Fertility and pregnancy-related issues are critical for young patients with breast cancer. No proper evidence exists on physicians' knowledge, practice, and attitudes on dealing with these concerns in the specific group of patients with advanced disease.
A 26-item questionnaire was administered via e-mail in December 2023 to physicians who attended the ABC6 consensus conference (virtually, November 2021) and those who were registered for the ABC7 consensus conference (Lisbon, November 2023). The questionnaire was divided into 3 main sections: 1) demographic, medical training, and background information; 2) knowledge, practice, and attitudes of physicians towards fertility preservation and pregnancy-related issues in patients with advanced breast cancer; 3) approach to hypothetical clinical cases.
A total of 133 physicians completed the survey. Most reported discussing always (40.6 %) or usually (36.1 %) the possible treatment-related loss of ovarian function in patients with advanced breast cancer. Regarding fertility preservation and pregnancy-related issues, 23.3 % would always feel comfortable discussing these topics with patients, and 45.9 % would feel comfortable depending on the clinical situation. 20.3 % reported not prescribing any type of contraception, and 10-20 % would prescribe treatments that are contraindicated during pregnancy.
Our survey showed that many concerns exist when discussing and dealing with fertility and pregnancy-related issues in patients with advanced breast cancer. It is essential to increase physicians' awareness on how to address fertility and pregnancy-related issues in patients with advanced breast cancer, especially as oncological treatments continue to improve, resulting in longer survival and, in some cases, potential cure.
生育及与妊娠相关的问题对于年轻乳腺癌患者至关重要。对于晚期疾病这一特定患者群体，在医生处理这些问题的知识、实践及态度方面，尚无充分证据。
2023年12月通过电子邮件向参加ABC6共识会议（线上，2021年11月）的医生以及注册参加ABC7共识会议（里斯本，2023年11月）的医生发放了一份包含26个条目的问卷。问卷分为3个主要部分：1）人口统计学、医学培训及背景信息；2）医生对晚期乳腺癌患者生育力保存及与妊娠相关问题的知识、实践及态度；3）对假设临床病例的处理方法。
共有133名医生完成了调查。大多数医生报告总是（40.6%）或通常（36.1%）会讨论晚期乳腺癌患者可能因治疗导致的卵巢功能丧失。关于生育力保存及与妊娠相关的问题，23.3%的医生总是会自在地与患者讨论这些话题，45.9%的医生会根据临床情况感到自在。20.3%的医生报告未开具任何类型的避孕措施，10 - 20%的医生会开具孕期禁忌的治疗药物。
我们的调查显示，在讨论和处理晚期乳腺癌患者的生育及与妊娠相关问题时存在诸多顾虑。提高医生对如何处理晚期乳腺癌患者生育及与妊娠相关问题的认识至关重要，尤其是随着肿瘤治疗不断改善，患者生存期延长，在某些情况下甚至可能治愈。
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