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Contraception counseling for young breast cancer patients: A practical needs assessment and a survey among medical oncologists
Affiliation:1. Cantonal Hospital Winterthur, Department of Gynecology and Obstetrics, Breast Center “Senosuisse”, Brauerstrasse 15, CH-8401 Winterthur, Switzerland;2. University Hospital Basel (UHB), Women''s Hospital, Division for Gynecology and Gynecological Oncology, Spitalstrasse 21, CH-4031 Basel, Switzerland;3. UHB, Women''s Hospital, Clinic for Gynecologic Social Medicine and Psychosomatics, Spitalstrasse 21, CH-4031 Basel, Switzerland;4. Cantonal Hospital Baselland, Department of Gynecology and Obstetrics, Rheinstrasse 26, CH-4410 Liestal, Switzerland;5. UHB, Women''s Hospital, Clinic for Gynecologic Endocrinology and Reproductive Medicine, Spitalstrasse 21, CH-4031 Basel, Switzerland;6. Fertisuisse, Center for Reproductive Medicine, Tannwaldstrasse 2, CH-4600 Olten, Switzerland;1. Service de Pneumologie A, Assistance Publique Hôpitaux de Paris, Hôpital Bichat, Université Paris Diderot, Paris, France;2. Service de Médecine Interne, Centre Hospitalo-universitaire, Sud Réunion, Saint Pierre, France;3. Service de Pharmacie Clinique et des Biomatériaux, Assistance Publique Hôpitaux de Paris, Hôpital Bichat, Paris, France;1. Department of Biostatistics, Faculty of Public Health, Hasanuddin University, Indonesia;2. Department of Occupational Health and Safety, Faculty of Public Health, Hasanuddin University, Indonesia;1. Department of Obstetrics and Gynecology, University of Split, Split University Medical Centre, Split, Croatia;2. Department of Obstetrics and Gynecology, University of Zagreb, Zagreb University Medical Centre, Zagreb, Croatia;3. Department of Research in Biomedicine and Health, University of Split School of Medicine, Split, Croatia;1. Department of Gynecology and Obstetrics, St. Josefskrankenhaus, Teaching Hospital of the University of Freiburg, Freiburg, Germany;2. Institute of Pathology “Dr. Möckel & Dr. Schneider”, Freiburg, Germany;1. Department of Obstetrics and Gynecology, Regina General Hospital, University of Saskatchewan, Saskatchewan, Canada;2. Department of Radiology, Regina General Hospital, University of Saskatchewan, Saskatchewan, Canada;3. University of Saskatchewan Medical School, Regina General Hospital, University of Saskatchewan, Saskatchewan, Canada
Abstract:Background/methodsWe analyzed an unselected, consecutive cohort of young breast cancer (BC) patients (≤40 years, n = 100) with regard to the contraceptive methods used at the time of diagnosis. Based on this data, we assessed the individual need for contraceptive counseling before cancer therapy. Secondly, in a study-specific self-report questionnaire, we surveyed 101 medical oncologists with the aim of evaluating attitudes towards contraception and how young patients are being counseled in the practical clinical setting.ResultsIn 62% of our cohort of young BC patients, we identified situations in which contraceptive counseling was necessary at the time of BC diagnosis. The patients did not use contraception or used an ineffective method (TIER III/IV, 42%), or were using hormonal methods (12%) or IUDs (8%).Almost all respondents of the survey (99%) stated that contraception is an important aspect in the surveillance of young BC patients and the vast majority (90%) discussed this item before starting therapy. Only 20% of the respondents reported that they a) inform the patients that reliable contraception is necessary before starting therapy, b) ask whether contraceptive methods are used during ongoing therapy, and c) regularly refer their patients to specialist counseling by a gynecologist.ConclusionsA large proportion of young women require contraceptive counseling after newly diagnosed BC. Oncologists should be aware that the use of reliable contraceptive methods should not only be discussed before starting therapy, but also during ongoing therapy. Oncologists should consider actively referring their young patients to gynecologists to ensure proper contraceptive counseling.
Keywords:Breast cancer  Contraception  Fertility  Oncologist
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