title: Oncofertility Knowledge, Attitudes, and Practices of Canadian Breast Surgeons.
abstract: Guidelines recommend that oncologists discuss treatment-related fertility issues with young cancer patients as early as possible after diagnosis and, if appropriate, expedite referral for fertility preservation (FP). This study sought to determine the attitudes and practices of Canadian breast surgeons regarding fertility issues, as well as barriers to and facilitators of fertility discussion and referrals.
  
  
  
  Semistructured telephone interviews were conducted with 28 site lead surgeons (SLSs) at 28 (97 %) of 29 centers (25 % cancer centers, 64 % teaching hospitals) across Canada participating in RUBY, a pan-Canadian research program for young women with breast cancer. In addition, 56 (65 %) of 86 of their surgical colleagues (non-site lead surgeons [NSLSs]) completed an online survey of their oncofertility knowledge, attitudes, and practices.
  
  
  
  Of the 28 SLSs (43 % male, 36 % in practice <10 years), 46 % had inadequate oncofertility knowledge, 25 % discussed fertility only if mentioned by the patient, 21 % believed fertility discussion and referral were the mandate of the medical oncologist, and 45 % did not know of an FP center in their area. More than 80 % of the NSLSs (54 % male, 30 % in practice <10 years) were unfamiliar with oocyte or embryo cryopreservation; 36 % never or rarely discussed fertility issues; and 51 % thought referral to a fertility specialist was not their responsibility.
  
  
  
  Oncofertility knowledge was low among the SLSs, especially the NSLSs, and barriers to referral were identified. An oncofertility knowledge translation intervention specifically for breast surgeons is being developed to increase surgeon knowledge and awareness of oncofertility issues and referral.
authors.affiliation: Division of Medical Oncology, Sunnybrook Odette Cancer Centre, Toronto, ON, Canada. ellen.warner@sunnybrook.ca.|University of Toronto, Toronto, ON, Canada. ellen.warner@sunnybrook.ca.
authors.forename: Ellen
authors.initials: E
authors.lastname: Warner
authors.affiliation: CReATe Fertility Centre, Toronto, ON, Canada.
authors.forename: Samantha
authors.initials: S
authors.lastname: Yee
authors.affiliation: University of Toronto, Toronto, ON, Canada.|Mount Sinai Hospital, Toronto, ON, Canada.
authors.forename: Erin
authors.initials: E
authors.lastname: Kennedy
authors.affiliation: University of Toronto, Toronto, ON, Canada.|CReATe Fertility Centre, Toronto, ON, Canada.
authors.forename: Karen
authors.initials: K
authors.lastname: Glass
authors.affiliation: Regional Fertility Program, Calgary, AB, Canada.|University of Calgary, Calgary, AB, Canada.
authors.forename: Shu
authors.initials: S
authors.lastname: Foong
authors.affiliation: Division of Medical Oncology, Sunnybrook Odette Cancer Centre, Toronto, ON, Canada.
authors.forename: Maureen
authors.initials: M
authors.lastname: Seminsky
authors.affiliation: University of Calgary, Calgary, AB, Canada.|Tom Baker Cancer Centre, Calgary, AB, Canada.
authors.forename: May Lynn
authors.initials: ML
authors.lastname: Quan
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001943:Breast Neoplasms; D002170:Canada; D002983:Clinical Competence; D003142:Communication; D015925:Cryopreservation; D004622:Embryo, Mammalian; D005260:Female; D005298:Fertility; D059247:Fertility Preservation; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009865:Oocytes; D010819:Physician's Role; D010817:Physician-Patient Relations; D000071077:Surgical Oncology; D011795:Surveys and Questionnaires