Annals of Surgical Oncology

, Volume 23, Issue 12, pp 3850–3859 | Cite as

Oncofertility Knowledge, Attitudes, and Practices of Canadian Breast Surgeons

  • Ellen Warner
  • Samantha Yee
  • Erin Kennedy
  • Karen Glass
  • Shu Foong
  • Maureen Seminsky
  • May Lynn Quan
Breast Oncology



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.


Breast Cancer Ruby Fertility Preservation Premature Ovarian Failure Breast Surgeon 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



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.


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Copyright information

© Society of Surgical Oncology 2016

Authors and Affiliations

  • Ellen Warner
    • 1
    • 2
  • Samantha Yee
    • 3
  • Erin Kennedy
    • 2
    • 4
  • Karen Glass
    • 2
    • 3
  • Shu Foong
    • 5
    • 6
  • Maureen Seminsky
    • 1
  • May Lynn Quan
    • 6
    • 7
  1. 1.Division of Medical OncologySunnybrook Odette Cancer CentreTorontoCanada
  2. 2.University of TorontoTorontoCanada
  3. 3.CReATe Fertility CentreTorontoCanada
  4. 4.Mount Sinai HospitalTorontoCanada
  5. 5.Regional Fertility ProgramCalgaryCanada
  6. 6.University of CalgaryCalgaryCanada
  7. 7.Tom Baker Cancer CentreCalgaryCanada

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