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Web-Based Survey of Fertility Issues in Young Women With Breast Cancer

From the Dana-Farber Cancer Institute, Brigham and Women’s Hospital, and Harvard Medical School, Boston, MA; and Young Survival Coalition, New York, NY

Address reprint requests to Ann H. Partridge, MD, MPH, Dana-Farber Cancer Institute, 44 Binney St, D1210, Boston, MA 02115; e-mail: ahpartridge{at}partners.org

PURPOSE: Young women with breast cancer often seek advice about whether treatment will affect their fertility. We sought to gain a better understanding of women’s attitudes about fertility and how these concerns affect decision making.

PATIENTS AND METHODS: We developed a survey about fertility issues for young women with a history of early-stage breast cancer. The survey was e-mailed to all registered Young Survival Coalition survivor members (N = 1,702). E-mail reminders were used.

RESULTS: Six hundred fifty-seven eligible respondents completed the survey. Mean age at breast cancer diagnosis was 32.9 years; mean current age was 35.8 years. Ninety percent of women were white; 62% were married; 76% were college graduates. Stages at diagnosis were as follows: 0, 10%; I, 27%; II, 47%; III, 13%. Sixty-two percent of women were within 2 years of diagnosis. Fifty-seven percent recalled substantial concern at diagnosis about becoming infertile with treatment. In multivariate logistic regression, greater concern about infertility was associated with wish for children/more children (odds ratio [OR], 120; P < .0001), number of prior pregnancies (OR, 0.78; P = .01), and prior difficulty conceiving (OR, 1.86; P = .08). Twenty-nine percent of women reported that infertility concerns influenced treatment decisions. Seventy-two percent of women reported discussing fertility concerns with their doctors; 51% felt their concerns were addressed adequately. Women seemed to overestimate their risk of becoming postmenopausal with treatment.

CONCLUSION: Fertility after treatment is a major concern for young women with breast cancer. There is a need to communicate with and educate young patients regarding fertility issues at diagnosis and a need for future research directed at preserving fertility for young breast cancer survivors.

Authors’ disclosures of potential conflicts of interest are found at the end of this article.

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