title: Physicians' knowledge, attitude, and behavior regarding fertility issues for young breast cancer patients: a national survey for breast care specialists.
abstract: BACKGROUND
  Fertility is one of the key aspects of quality of life for breast cancer patients of childbearing age. The objective of this study was to describe fertility-related practice for young breast cancer patients in Japan and to identify healthcare provider factors that contribute to physicians' behavior towards fertility preservation.
  
  
  METHODS
  A cross-sectional survey was developed in order for Japanese breast cancer specialists (n = 843) to self-evaluate their knowledge, attitude, and behavior regarding fertility preservation. Survey items included questions regarding knowledge of and attitude toward fertility issues in cancer patients, fertility-related practice, potential barriers for the discussion of fertility with patients, and responding physicians' socio-demographic background.
  
  
  RESULTS
  Four hundred and thirty-four (52%) breast oncologists responded to the survey. Female and younger oncologists (age less than 50 years) had significantly higher probability of referring patients to reproductive specialists. Physicians who had better knowledge score and positive attitudes toward fertility preservation were more likely to discuss potential fertility issues with cancer patients. This was significantly associated with consultation and referral to reproduction specialists when encountering fertility issues with cancer patients. Risk of recurrence, lack of collaborating reproductive specialists, and time constraints in the clinic were identified as major barriers to discussion of fertility preservation with breast cancer patients.
  
  
  CONCLUSIONS
  Female and younger physicians as well as physicians working in a multidisciplinary environment had positive attitudes and behavior towards fertility preservation in breast cancer patients. The development of comprehensive and interdisciplinary programs for healthcare providers is necessary to meet the expectations and fertility needs of breast cancer patients.
authors.affiliation: Breast and Medical Oncology Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan. cshimizu@ncc.go.jp
authors.forename: Chikako
authors.initials: C
authors.lastname: Shimizu
authors.forename: Hiroko
authors.initials: H
authors.lastname: Bando
authors.forename: Tomoyasu
authors.initials: T
authors.lastname: Kato
authors.forename: Yuri
authors.initials: Y
authors.lastname: Mizota
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Fujiwara
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001943:Breast Neoplasms / Q000523:psychology* / Q000628:therapy; D003430:Cross-Sectional Studies; D005260:Female; D059247:Fertility Preservation / Q000523:psychology*; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007564:Japan; D008297:Male; D008495:Medical Oncology; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011379:Prognosis; D011788:Quality of Life; D012307:Risk Factors; D013038:Specialization; D011795:Surveys and Questionnaires; D055815:Young Adult