Physician Perspectives on Fertility Preservation Discussions with Premenopausal Breast Cancer Patients: Results from a Multihospital Health Care System.

MedStar author(s):
Citation: Annals of Surgical Oncology. 2019 Jul 24PMID: 31342399Institution: MedStar Washington Hospital CenterDepartment: Surgery/Plastic SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Breast Neoplasms/px [Psychology] | *Communication | *Fertility Preservation/px [Psychology] | *Health Knowledge, Attitudes, Practice | *Medical Oncology/sn [Statistics & Numerical Data] | *Physicians/sn [Statistics & Numerical Data] | *Practice Patterns, Physicians'/sn [Statistics & Numerical Data] | Breast Neoplasms/dt [Drug Therapy] | Female | Humans | Patient Education as Topic | Physicians/px [Psychology] | Premenopause | Referral and ConsultationYear: 2019Local holdings: Available online from MWHC library: 1994 - presentISSN:
  • 1068-9265
Name of journal: Annals of surgical oncologyAbstract: BACKGROUND: Ten percent of new breast cancer diagnoses occur in premenopausal women, and oncologic therapies may compromise fertility. Thus, fertility preservation discussions (FPDs) and referral to fertility specialists are imperative prior to initiation of therapy. A previous retrospective chart review showed 45% FPD rates at our institution. The aim of this study is to investigate physician perspectives and limitations regarding FPD.CONCLUSIONS: Fertility preservation is an integral aspect of breast cancer care, requiring thorough discussion and clear documentation. This study identified that physicians believe the medical oncologist is the most appropriate person to have FPDs with patients and that empowering patients to bring up fertility concerns may improve rates of FPDs. Education of physicians and patients about fertility preservation techniques is likely to improve FPDs.METHODS: An electronic survey was distributed to 30 surgical, medical, and radiation oncologists across ten regional hospitals. Questions addressed provider demographics, and barriers to and facilitators of FPD.RESULTS: The survey response rate was 63.3%. Only 31.6% of physicians reported "always" documenting FPD. Respondents opined that the physician prescribing systemic therapy was the most appropriate person to provide FPD. Patient age, treatment with chemotherapy, and patient desire for FPD were more likely to increase FPD (p < 0.0001, p < 0.05, and p < 0.0001, respectively). The majority of physicians (84.2%) expressed intent to increase FPD rates.All authors: Bartholomew AJ, Bozzuto LM, Haslinger M, Masciello MC, Thibodeau R, Tsiapali EV, Tung SSOriginally published: Annals of Surgical Oncology. 26(10):3210-3215, 2019 Oct.Fiscal year: FY2020Digital Object Identifier: Date added to catalog: 2019-08-23
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Journal Article MedStar Authors Catalog Article 31342399 Available 31342399

Available online from MWHC library: 1994 - present

BACKGROUND: Ten percent of new breast cancer diagnoses occur in premenopausal women, and oncologic therapies may compromise fertility. Thus, fertility preservation discussions (FPDs) and referral to fertility specialists are imperative prior to initiation of therapy. A previous retrospective chart review showed 45% FPD rates at our institution. The aim of this study is to investigate physician perspectives and limitations regarding FPD.

CONCLUSIONS: Fertility preservation is an integral aspect of breast cancer care, requiring thorough discussion and clear documentation. This study identified that physicians believe the medical oncologist is the most appropriate person to have FPDs with patients and that empowering patients to bring up fertility concerns may improve rates of FPDs. Education of physicians and patients about fertility preservation techniques is likely to improve FPDs.

METHODS: An electronic survey was distributed to 30 surgical, medical, and radiation oncologists across ten regional hospitals. Questions addressed provider demographics, and barriers to and facilitators of FPD.

RESULTS: The survey response rate was 63.3%. Only 31.6% of physicians reported "always" documenting FPD. Respondents opined that the physician prescribing systemic therapy was the most appropriate person to provide FPD. Patient age, treatment with chemotherapy, and patient desire for FPD were more likely to increase FPD (p < 0.0001, p < 0.05, and p < 0.0001, respectively). The majority of physicians (84.2%) expressed intent to increase FPD rates.

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