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Discussions Regarding Reproductive Health for Young Women With Breast Cancer Undergoing Chemotherapy

From Brown University and Rhode Island Hospital, Providence, RI

Address reprint requests to Christine M. Duffy, MD, MPH, Assistant Professor of Medicine, Brown University Medical School, Division of General Internal Medicine—Research, Rhode Island Hospital, 55 Eddy St, Providence, RI 02903; e-mail: Christine_Duffy{at}Brown.edu

PURPOSE: Young women who undergo chemotherapy for breast cancer face serious consequences to their reproductive health. Research in this area has previously focused on men, or on childhood cancer survivors. We sought to explore self-report of reproductive health counseling in young women undergoing chemotherapy for breast cancer.

PATIENTS AND METHODS: A total of 166 premenopausal women aged 50 years were recruited from oncology offices in academic and private practices in four northeastern states, as part of a randomized controlled clinical trial aimed at stress reduction. Women were asked a variety of questions regarding diagnosis and treatment, including whether they received any counseling regarding early menopause and fertility issues.

RESULTS: Sixty-eight percent and 34% of women reported recalling a discussion with a physician regarding early menopause or fertility, respectively. In multivariate analysis, hormonal therapy and early stage of disease were associated with significantly increased odds of recall of a discussion regarding menopause. Difficulty communicating with medical team was associated with increased odds of recalling a discussion regarding fertility, whereas older age and anxiety in medical situations were associated with decreased odds.

CONCLUSION: Many women fail to recall discussions regarding the reproductive health impact of chemotherapy. Demographic, psychological, and disease-related variables are related to recalling such discussions. Counseling about premature menopause and fertility changes is an overlooked aspect of preparation for adjuvant chemotherapy in young premenopausal women with breast cancer. Future research should explore this issue further.

Supported in part by a grant from the National Cancer Institute, Grant No. CA64703.

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

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