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Fertility- and Menopause-Related Information Needs of Younger Women With a Diagnosis of Early Breast Cancer

From the Department of Medical Oncology, Prince of Wales Hospital, Randwick; Department of Psychology, Macquarie University; Department of Radiation Oncology, Royal Prince Alfred Hospital; Department of Medical Oncology, St Vincent's Hospital; Australia Department of Obstetrics and Gynaecology, Royal North Shore Hospital, Sydney; Department of Hematology and Medical Oncology, Peter MacCallum Cancer Centre, Melbourne; and Illawarra Cancer Care Centre, Wollongong Hospital, Wollongong, Australia

Address reprint requests to Belinda Thewes, Department of Medical Oncology, Prince of Wales Hospital, Randwick, New South Wales 2031, Australia; e-mail: b.thewes{at}unsw.edu.au

PURPOSE: The use of chemotherapy and endocrine therapies in the treatment of premenopausal women carries with it reproductive and gynecologic implications that young women may find distressing and discordant with plans for childbearing. This multicenter study aimed to investigate fertility- and menopause-related information needs among young women with a diagnosis of early-stage breast cancer.

PATIENTS AND METHODS: Two hundred twenty-eight women with a diagnosis of early-stage breast cancer who were aged 40 years or younger at diagnosis and who were 6 to 60 months after diagnosis were entered onto the trial. Participants completed a mailed self-report questionnaire that included a purposely designed fertility- and menopause-related information needs survey and standardized measures of distress, anxiety, quality of life, menopausal symptoms, and information-seeking style.

RESULTS: Seventy-one percent of participants discussed fertility-related issues with a health professional as part of their breast cancer treatment, and 86% discussed menopause-related issues. Consultation with a fertility or menopause specialist was the most preferred method of obtaining this information. Receiving fertility-related information was rated as being significantly more important than receiving menopause-related information at time of diagnosis (P < .001) and at treatment decision making (P = .058). Receiving menopause-related information was rated as being significantly more important than receiving fertility-related information during adjuvant treatment (P < .05), at completion of adjuvant treatment (P < .001), and during follow-up (P < .001). Common questions, sources of information, and correlates of perceived importance were identified.

CONCLUSION: The results of this study suggest that younger women have unmet needs for fertility- and menopause-related information and provide preliminary empirical data to guide the development of better fertility- and menopause-related patient education materials for younger women with a diagnosis of early breast cancer.

Supported by a National Breast Cancer Foundation "National Association of Women in Superannuation Post-Graduate Scholarship" (B.T.), a National Health and Medical Research Council of Australia Public Health Fellowship (B.M.), and an unrestricted educational grant-in-aid from AstraZeneca.

This work was undertaken as part of a conjoint appointment (M.L.F. and B.M.) at the Prince of Wales Hospital Clinical School, University of New South Wales, Randwick, Australia.

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

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