Which patients pursue fertility preservation treatments? A multicenter analysis of the predictors of fertility preservation in women with breast cancer.
OBJECTIVE
To evaluate predictors of undergoing fertility preservation treatment (FPT) in women with breast cancer.


METHODS
Secondary analysis of a clinical database.


METHODS
Three academic fertility preservation centers.


METHODS
One hundred eight patients with breast cancer undergoing FPT and 77 patients with breast cancer not undergoing FPT from 2005 to 2010.


METHODS
None.


METHODS
Patients' demographic and medical information.


RESULTS
Women who had FPT were older, wealthier, and had lower cancer stage compared with women who did not have FPT. The rate of the administration of neoadjuvant chemotherapy (NAC) was significantly lower in women who underwent FPT. After adjusting for age, body mass index (BMI), income, cancer stage, and center, a negative correlation persisted between NAC and FPT (odds ratio 0.091, 95% confidence interval 0.009-0.904). When we stratified the women by center, women at center 1 had a significantly lower FPT rate, lower parity, higher BMI, more advanced cancer stage, and lower income compared with centers 2 and 3. The rates of NAC were significantly higher in center 1.


CONCLUSIONS
Although age, BMI, income, cancer stage, center, and NAC seem to be associated with undergoing FPT, NAC is the only modifiable variable. Because NAC restricts the time available for FPT, oncologists may consider offering adjuvant chemotherapy, except in cases in which NAC clearly improves survival, in women who are interested in FPT.
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina 27599-7570, USA.
Jayeon
J
Kim
Kutluk
K
Oktay
Clarisa
C
Gracia
Sanghoon
S
Lee
Christopher
C
Morse
Jennifer E
JE
Mersereau
D000046:Academic Medical Centers; D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000150:complications / Q000473:pathology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D016009:Chi-Square Distribution; D005260:Female; D059247:Fertility Preservation; D006801:Humans; D007182:Income; D007247:Infertility, Female / Q000209:etiology / Q000628:therapy*; D016015:Logistic Models; D020360:Neoadjuvant Therapy / Q000009:adverse effects; D009367:Neoplasm Staging; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States