Knowledge, attitudes and practice of physicians towards fertility and pregnancy-related issues in youngBRCA-mutated breast cancer patients: Reproductive BioMedicine Online

M. Lambertini, M. Di Maio, F. Poggio, O. Pagani, G. Curigliano, L.D. Mastro, S. Paluch-Shimon, S. Loibl, A.H. Partridge, Jr Azim H.A., F.A. Peccatori, I. Demeestere

Research output: Contribution to journalArticlepeer-review

Abstract

Research question: This study explored the knowledge, attitudes and practice of physicians towards fertility and pregnancy-related issues in young BRCA-mutated breast cancer patients. Design: Physicians attending two international breast cancer conferences completed a 26-item questionnaire exploring fertility preservation, pregnancy during (BCP) or after breast cancer. A statistical comparison was carried out of the responses exploring the same issues in young breast cancer patients overall or specifically in those with BRCA mutations. Results: The survey was completed by 273 physicians. Ovarian tissue cryopreservation (33% versus 40%; P = 0.009) and gonadotrophin-releasing hormone analogues during chemotherapy (74% versus 81%; P = 0.001) were less commonly suggested in BRCA-mutated patients than in the overall breast cancer population. 42% of respondents agreed or were neutral on the statement that ovarian stimulation should not be considered safe in BRCA-mutated breast cancer patients. 45% and 30% agreed or were neutral on the statement that pregnancy in breast cancer survivors may increase the risk of recurrence in BRCA-mutated patients or in the overall breast cancer population, respectively (P <0.001). 15% and 3% disagreed that transplanting the cryopreserved ovarian tissue can be considered safe in BRCA-mutated patients or in the overall breast cancer population, respectively (P <0.001). 33.3% were against the addition of platinum agents as neoadjuvant chemotherapy in BRCA-mutated patients with BCP. Conclusions: Several misconceptions on fertility preservation and pregnancy-related issues in breast cancer patients persist even among physicians directly involved in breast cancer care. Focused research efforts to address these issues in BRCA-mutated breast cancer patients and education to improve physicians’ knowledge and adherence to available guidelines are urgently needed. © 2019 Reproductive Healthcare Ltd.
Original languageEnglish
Pages (from-to)835-844
Number of pages10
JournalReprod. BioMed. Online
Volume38
Issue number5
DOIs
Publication statusPublished - 2019

Keywords

  • BRCA mutations
  • breast cancer
  • fertility preservation
  • physicians
  • pregnancy
  • survey
  • antineoplastic agent
  • gonadorelin
  • adult
  • Article
  • brca gene
  • cancer chemotherapy
  • cancer patient
  • clinical practice
  • cryopreservation
  • female
  • gene
  • gene mutation
  • human
  • male
  • neoadjuvant chemotherapy
  • ovary tissue
  • physician attitude
  • professional knowledge
  • questionnaire
  • risk factor
  • small for date infant

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