title: Attitudes of young patients with breast cancer toward fertility loss related to adjuvant systemic therapies. EORTC study 10002 BIG 3-98.
abstract: OBJECTIVE
  Infertility due to anticancer treatments is a major source of distress for young patients with cancer. A survey was performed among breast cancer patients younger than 35 years, to evaluate the acceptance of chemotherapy in the context of infertility risk.
  
  
  METHODS
  After obtaining written informed consent, we asked 400 premenopausal, early stage breast cancer patients aged ≤35 years to complete a short, previously pilot-tested questionnaire. Three hundred and eighty-nine patients were evaluable. The association between the explanatory variables and the outcome variables was assessed using logistic regression.
  
  
  RESULTS
  Two hundred and twenty-eight (59%) participants wanted to have (more) children in the future, whereas 158 (41%) did not. Fifty-seven (36%) of the latter did not want additional children because of fear of cancer recurrence. Thirty-two women (8%) stated they would not accept chemotherapy should it reduce their fertility. This was dependent upon already having children, the wish to have (further) children, geographical area, disease stage, and already planned chemotherapy. One hundred and seventy-one women who would agree to chemotherapy (48%) would accept a risk of infertility of 76-100%. This acceptance was dependent on already having children and the wish to have (more) children. Of the 355 participants (91%) accepting chemotherapy, 48 would accept it only for ≥20% gain in cure.
  
  
  CONCLUSIONS
  For the majority of young patients with breast cancer, cure remains their first priority; for this, they are willing to accept a considerable decrease in future fertility, and only less than 10% will forego chances of cure to preserve fertility.
authors.affiliation: Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Senkus
authors.forename: Henry
authors.initials: H
authors.lastname: Gomez
authors.forename: Luc
authors.initials: L
authors.lastname: Dirix
authors.forename: Guy
authors.initials: G
authors.lastname: Jerusalem
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Murray
authors.forename: Geertjan
authors.initials: G
authors.lastname: Van Tienhoven
authors.forename: A Helen
authors.initials: AH
authors.lastname: Westenberg
authors.forename: Andrew
authors.initials: A
authors.lastname: Bottomley
authors.forename: Jérôme
authors.initials: J
authors.lastname: Rapion
authors.forename: Jan
authors.initials: J
authors.lastname: Bogaerts
authors.forename: Angelo
authors.initials: A
authors.lastname: Di Leo
authors.forename: Zora
authors.initials: Z
authors.lastname: Nešković-Konstantinović
mesh_terms: D000328:Adult; D000367:Age Factors; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000188:drug therapy / Q000523:psychology*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects / Q000523:psychology*; D005191:Family Characteristics; D005260:Female; D059247:Fertility Preservation / Q000523:psychology*; D006801:Humans; D007246:Infertility / Q000139:chemically induced / Q000523:psychology*; D016015:Logistic Models; D015999:Multivariate Analysis; D057240:Patient Preference / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: breast cancer; chemotherapy, adjuvant; fertility preservation; young adult