Oncofertility Knowledge, Attitudes, and Practices of Canadian Breast Surgeons
- 299 Downloads
Guidelines recommend that oncologists discuss treatment-related fertility issues with young cancer patients as early as possible after diagnosis and, if appropriate, expedite referral for fertility preservation (FP). This study sought to determine the attitudes and practices of Canadian breast surgeons regarding fertility issues, as well as barriers to and facilitators of fertility discussion and referrals.
Semistructured telephone interviews were conducted with 28 site lead surgeons (SLSs) at 28 (97 %) of 29 centers (25 % cancer centers, 64 % teaching hospitals) across Canada participating in RUBY, a pan-Canadian research program for young women with breast cancer. In addition, 56 (65 %) of 86 of their surgical colleagues (non-site lead surgeons [NSLSs]) completed an online survey of their oncofertility knowledge, attitudes, and practices.
Of the 28 SLSs (43 % male, 36 % in practice <10 years), 46 % had inadequate oncofertility knowledge, 25 % discussed fertility only if mentioned by the patient, 21 % believed fertility discussion and referral were the mandate of the medical oncologist, and 45 % did not know of an FP center in their area. More than 80 % of the NSLSs (54 % male, 30 % in practice <10 years) were unfamiliar with oocyte or embryo cryopreservation; 36 % never or rarely discussed fertility issues; and 51 % thought referral to a fertility specialist was not their responsibility.
Oncofertility knowledge was low among the SLSs, especially the NSLSs, and barriers to referral were identified. An oncofertility knowledge translation intervention specifically for breast surgeons is being developed to increase surgeon knowledge and awareness of oncofertility issues and referral.
KeywordsBreast Cancer Ruby Fertility Preservation Premature Ovarian Failure Breast Surgeon
This study was supported by a Grant from the Canadian Breast Cancer Foundation and Canadian Institutes of Health Research (#OBW139590).
There are no conflict of interest.
- 5.Mathews TJ, Hamilton BE. Delayed Childbearing: More Women Are Having Their First Child Later in Life. NCHS Data Brief, no. 21. NationalCenter for Health Statistics, Hyattsville, MD, 2009.Google Scholar
- 9.Davies C, Pan H, Godwin J, et al .Adjuvant Tamoxifen: Longer Against Shorter (ATLAS) Collaborative Group. Long-term effects of continuing adjuvant tamoxifen to 10 years vs stopping at 5 years after diagnosis of estrogen receptor positive breast cancer: ATLAS, a randomised trial. Lancet. 2013:381:805–16.CrossRefPubMedPubMedCentralGoogle Scholar
- 20.Strauss, A. Basics of qualitative research: techniques and procedures for developing grounded theory. Sage, Thousand Oaks, CA, 1998.Google Scholar