title: Contraception counseling for young breast cancer patients: A practical needs assessment and a survey among medical oncologists.
abstract: METHODS
  We analyzed an unselected, consecutive cohort of young breast cancer (BC) patients (≤40 years, n = 100) with regard to the contraceptive methods used at the time of diagnosis. Based on this data, we assessed the individual need for contraceptive counseling before cancer therapy. Secondly, in a study-specific self-report questionnaire, we surveyed 101 medical oncologists with the aim of evaluating attitudes towards contraception and how young patients are being counseled in the practical clinical setting.
  
  
  RESULTS
  In 62% of our cohort of young BC patients, we identified situations in which contraceptive counseling was necessary at the time of BC diagnosis. The patients did not use contraception or used an ineffective method (TIER III/IV, 42%), or were using hormonal methods (12%) or IUDs (8%). Almost all respondents of the survey (99%) stated that contraception is an important aspect in the surveillance of young BC patients and the vast majority (90%) discussed this item before starting therapy. Only 20% of the respondents reported that they a) inform the patients that reliable contraception is necessary before starting therapy, b) ask whether contraceptive methods are used during ongoing therapy, and c) regularly refer their patients to specialist counseling by a gynecologist.
  
  
  CONCLUSIONS
  A large proportion of young women require contraceptive counseling after newly diagnosed BC. Oncologists should be aware that the use of reliable contraceptive methods should not only be discussed before starting therapy, but also during ongoing therapy. Oncologists should consider actively referring their young patients to gynecologists to ensure proper contraceptive counseling.
authors.affiliation: Cantonal Hospital Winterthur, Department of Gynecology and Obstetrics, Breast Center "Senosuisse", Brauerstrasse 15, CH-8401 Winterthur, Switzerland; University Hospital Basel (UHB), Women's Hospital, Division for Gynecology and Gynecological Oncology, Spitalstrasse 21, CH-4031 Basel, Switzerland. Electronic address: uwe.gueth@unibas.ch.
authors.forename: Uwe
authors.initials: U
authors.lastname: Güth
authors.affiliation: University Hospital Basel (UHB), Women's Hospital, Division for Gynecology and Gynecological Oncology, Spitalstrasse 21, CH-4031 Basel, Switzerland.
authors.forename: Dorothy Jane
authors.initials: DJ
authors.lastname: Huang
authors.affiliation: UHB, Women's Hospital, Clinic for Gynecologic Social Medicine and Psychosomatics, Spitalstrasse 21, CH-4031 Basel, Switzerland.
authors.forename: Johannes
authors.initials: J
authors.lastname: Bitzer
authors.affiliation: Cantonal Hospital Baselland, Department of Gynecology and Obstetrics, Rheinstrasse 26, CH-4410 Liestal, Switzerland.
authors.forename: Brigitte Frey
authors.initials: BF
authors.lastname: Tirri
authors.affiliation: UHB, Women's Hospital, Clinic for Gynecologic Endocrinology and Reproductive Medicine, Spitalstrasse 21, CH-4031 Basel, Switzerland; Fertisuisse, Center for Reproductive Medicine, Tannwaldstrasse 2, CH-4600 Olten, Switzerland.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Moffat
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000628:therapy*; D003267:Contraception / Q000379:methods / Q000706:statistics & numerical data*; D003376:Counseling; D003430:Cross-Sectional Studies; D005260:Female; D006176:Gynecology; D006801:Humans; D008495:Medical Oncology; D020380:Needs Assessment; D000072103:Oncologists; D011446:Prospective Studies; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D013557:Switzerland
keywords: Breast cancer; Contraception; Fertility; Oncologist