title: Young breast cancer survivors: their perspectives on treatment decisions and fertility concerns.
abstract: BACKGROUND
  Younger women diagnosed with breast cancer are more likely to have survival concerns related to fertility, which may influence their treatment decisions.
  
  
  OBJECTIVE
  This qualitative study explores how young women make cancer treatment decisions and the role of fertility concerns in that process.
  
  
  METHODS
  We used purposeful sampling to identify a diverse group of 20 young breast cancer survivors, half of whom had a child after breast cancer. We conducted open-ended telephone interviews and used cross-case, inductive analysis to identify themes.
  
  
  RESULTS
  The main themes were (1) "I was young, I wanted to do everything possible to move forward with my life and not to have the cancer come back"; (2) "Fertility concerns are different for every woman"; (3) "My oncologist was great… a huge part of my survivorship"; and (4) "They didn't tell me about my options, and I didn't think about fertility until it was too late."
  
  
  CONCLUSIONS
  Although fertility was important to many participants, treatment decisions were mainly motivated by survival concerns. Fertility concerns depended on life circumstances, and the timing in relation to diagnosis varied. There is a need for improved information regarding the impact of treatment on fertility and fertility preservation options, even if concerns are not expressed at diagnosis.
  
  
  CONCLUSIONS
  It is critical that cancer care providers provide timely information regarding fertility. Oncology nurses are particularly well positioned to serve this role by communicating with patients about their fertility concerns and reproductive planning prior to treatment and throughout the course of survivorship.
authors.affiliation: Cancer Prevention and Control Program, Moores UCSD Cancer Center, University of California, San Diego, La Jolla, California, USA.
authors.forename: Jessica R
authors.initials: JR
authors.lastname: Gorman
authors.forename: Paula M
authors.initials: PM
authors.lastname: Usita
authors.forename: Lisa
authors.initials: L
authors.lastname: Madlensky
authors.forename: John P
authors.initials: JP
authors.lastname: Pierce
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000367:Age Factors; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000523:psychology* / Q000628:therapy; D005260:Female; D005298:Fertility; D006801:Humans; D017060:Patient Satisfaction; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D055815:Young Adult