Fertility concerns, preservation strategies and quality of life in young women with breast cancer: Baseline results from an ongoing prospective cohort study in selected European Centers

M. Ruggeri, E. Pagan, V. Bagnardi, N. Bianco, E. Gallerani, K. Buser, M. Giordano, L. Gianni, M. Rabaglio, A. Freschi, E. Cretella, M. Clerico, A. Farolfi, E. Simoncini, M. Ciccarese, D. Rauch, M. Ramello, A. Glaus, R. Berardi, A.F. PellandaK. Ribi, S. Gelber, A.H. Partridge, A. Goldhirsch, O. Pagani

Research output: Contribution to journalArticlepeer-review


Objectives: Most research addressing needs and concerns of young patients with breast cancer (≤40 years) is retrospective. The HOHO European protocol is a prospective multicenter cohort study of young women with newly diagnosed breast cancer, about fertility, psychosocial and quality of life concerns. Here we report the baseline data and focus on predictors of fertility concerns. Materials and methods: Patient surveys and medical record review were used. The baseline survey included sociodemographic, medical and treatment data as well as questions on fertility concerns and preservation strategies. Subscales from the CAncer Rehabilitation Evaluation System-Short Form (CARES-SF) were administered to measure specific quality of life aspects. Uni- and multivariable modeling were used to investigate predictors of greater fertility concern. Results: Among 297 eligible respondents, 67% discussed fertility issues before starting therapy, 64% were concerned about becoming infertile after treatment, and 15% decided not to follow prescribed therapies. Fifty-four percent of women wished future children before diagnosis; of these, 71% still desired biologic children afterwards. In multivariable analysis, not having children was the only patient characteristic significantly associated with fertility concerns at diagnosis. Twenty-seven percent used fertility preservation strategies. Women who received chemotherapy reported greater physical (p = 0.021) and sexual difficulties (p = 0.039) than women who did not. Women who were married or had a partner reported less psychosocial problems than single women (p = 0.039). Conclusions: Young women with newly diagnosed breast cancer have several concerns, including, but not limited to, fertility. The HOHO European study provides valuable information to develop targeted interventions. © 2019 Elsevier Ltd
Original languageEnglish
Pages (from-to)85-92
Number of pages8
Publication statusPublished - 2019


  • Breast cancer
  • Fertility concerns
  • Psychosocial aspects
  • Quality of life
  • Young women
  • adult
  • Article
  • breast cancer
  • cancer chemotherapy
  • cohort analysis
  • controlled study
  • demography
  • Europe
  • female
  • female fertility
  • fertility preservation
  • health survey
  • human
  • longitudinal study
  • major clinical study
  • married person
  • mastectomy
  • medical decision making
  • medical record review
  • molecularly targeted therapy
  • physical disease
  • prescription
  • priority journal
  • prospective study
  • quality of life
  • retrospective study
  • sexual dysfunction
  • age
  • breast tumor
  • clinical trial
  • comparative study
  • decision making
  • Italy
  • multicenter study
  • psychology
  • questionnaire
  • risk assessment
  • Switzerland
  • United States
  • Adult
  • Age Factors
  • Breast Neoplasms
  • Cohort Studies
  • Decision Making
  • Female
  • Fertility Preservation
  • Humans
  • Longitudinal Studies
  • Prospective Studies
  • Quality of Life
  • Risk Assessment
  • Surveys and Questionnaires


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