title: Experience of young women diagnosed with breast cancer who undergo fertility preservation consultation.
abstract: BACKGROUND
  Fertility preservation (FP) is of increasing concern to young patients with breast cancer. The American Society of Clinical Oncology has recommended referral to a reproductive specialist as early as possible before beginning systemic adjuvant therapy.
  
  
  OBJECTIVE
  To gather information from young patients with breast cancer about their experiences with FP referral, consultation, and decision making.
  
  
  METHODS
  An anonymous questionnaire was mailed to consecutive patients with breast cancer who were referred, from January 2005 to January 2010, from our center to the CReATe fertility clinic. Topics included demographics; cancer stage and treatment; previous fertility problems; referral source and timing; options presented and chosen; and satisfaction with the referral, consultation, and decision-making processes.
  
  
  RESULTS
  Of the 53 women identified, 27 (51%) participated. The mean age was 31 years (range, 24-41 years). Fifteen (56%) women opted for embryo or oocyte cryopreservation, 2 for ovarian suppression, and 10 for no FP. The choice was not affected by disease stage or by already having a child. Of the 22 women who responded, 14 (64%) were satisfied or very satisfied overall. Eighteen out of 23 (78%) respondents felt that the right amount of information was given. Thirty-nine percent had difficulty with decision making, but only 1 (4%) woman indicated that cost was a deciding factor. A common theme among respondents was inadequate time for decision making. A common complaint was the lack of written material before and/or after their consultation. Sixty-three percent expressed an interest in meeting with a psychosocial counselor.
  
  
  CONCLUSIONS
  (1) FP referral should be initiated by the surgeon as soon as a diagnosis of invasive cancer is made, (2) women need written materials before and after FP consultation is needed, and (3) a FP counselor who is able to spend additional time after the consultation could help with decision making.
authors.affiliation: Division of Medical Oncology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada. hill11ki@uregina.ca
authors.forename: Kimberley A
authors.initials: KA
authors.lastname: Hill
authors.forename: Tova
authors.initials: T
authors.lastname: Nadler
authors.forename: Rodica
authors.initials: R
authors.lastname: Mandel
authors.forename: Stephanie
authors.initials: S
authors.lastname: Burlein-Hall
authors.forename: Clifford
authors.initials: C
authors.lastname: Librach
authors.forename: Karen
authors.initials: K
authors.lastname: Glass
authors.forename: Ellen
authors.initials: E
authors.lastname: Warner
mesh_terms: D000328:Adult; D001943:Breast Neoplasms; D003657:Decision Making; D005260:Female; D059247:Fertility Preservation; D006801:Humans; D017060:Patient Satisfaction; D012017:Referral and Consultation; D055815:Young Adult