Study shows young women with breast cancer have more reproductive concerns and all should be offered fertility preservation counselling

New data presented at the recent European Organisation for Treatment and Research in Cancer (EORTC) 3rd International Quality of Life and Clinical Trials in Brussels shows that women undergoing breast cancer treatment are more likely to be concerned about their reproductive health than healthy women. The study’s authors, led by Mirjam Garvelink, Leiden University Medical Center, Netherlands, conclude that such women should be offered counselling about interventions such as fertility preservation treatment to help improve their quality of life.

The aim of this study was to investigate reproductive concerns of young breast cancer patients in a Dutch population, their association with psychological functioning and to investigate predictors of reproductive concerns.

Questionnaires were administered to a total of 235 women: 80 (34 percent) with breast cancer, 76 (32 percent) women with fertility problems and to 79 (34 percent) healthy controls from the general population. Reproductive concerns were measured with the Reproductive Concerns Scale (RCS) and psychological functioning was assessed with the Hospital Anxiety and Depression Scale (HADS).

Groups differed significantly in their RCS score: women with fertility problems had the highest RCS score (17.8), but the breast cancer group (11.2) scored higher than the healthy control group (4.7). Child wish was an important predictor of reproductive concerns, together with not having children, and living together with a partner. Breast cancer patients with a child wish reported significantly more reproductive concerns, were significantly younger, more recently diagnosed and were more depressed.

“The findings show that women with breast cancer report more reproductive concerns than healthy women and that these concerns are positively associated with symptoms of anxiety and depression,” says Garvelink. “The most important predictor of reproductive concerns was having a child wish. The difference in reproductive concerns and depression between patients with and without child wish was large. Therefore it is important to explore child wish and reproductive concerns of all young breast cancer patients in order to offer information about possible solutions (such as fertility preservation), to diminish concerns and thereby improve quality of life.”

She adds: “Unfortunately, information provision about fertility preservation is inadequate for many patients at the time of their breast cancer treatment, and physicians sometimes still base their judgment on whether or not to provide patients with this information on patient characteristics such as age, partner, sexual orientation and previous children. But our results show that having a child wish was not related to all these patient characteristics. Therefore, counselling about fertility preservation should be offered to all women at risk of losing their fertility due to oncology treatment, no matter their socio-demographic characteristics.”

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