Investigation On Female Fertility Demand Of Young Breast Cancer

Objective:In China, the prevalence of breast cancer in women is showing a trend of younger age. The time of diagnosis is 10-15 years earlier than western countries. More and more women have not met their childbearing needs at the time of diagnosis due to various reasons. The aim of this paper was to investigate whether young breast cancer women in China wanted to have children after diagnosis and treatment, factors that affected their childbearing needs, pregnancy after breast cancer, outcome of pregnancy and fertility counseling with clinicians. We hope that the results would give us insight into providing more individualized counseling and treatment plans for the patients in the daily clinical work so that the patients have more choices and opportunities to get pregnant after breast cancer. Only in this way can the patients be less worried about the childbearing problem and have better quality of life.Patients and Methods:This study is a single-center, random sampling and retrospective cross-sectional investigation. We selected patients from Cancer Hospital, Chinese Academy of Medical Sciences. Young breast cancer women(initial diagnosis at age no more than 40 years old) answered a questionnaire developed by the investigators. SPSS 20.0 statistical software was used to set up database and complete statistical analysis. Single and multiple factor binary logistic regression were used to investigate factors that affected childbearing needs.Results:308 young breast cancer women answered the questionnaire.81(26%) patients wanted to have children after breast cancer diagnosis and treatment. Of them,48 wanted to have their first child,33 wanted to have a second child. Of the women who had childbearing desires,6 have taken measures to preserve fertility, all of them had used GnRHa during chemotherapy; of the 6 patients,1 cryopreserved her oocytes before chemotherapy.8 patients tried to get pregnant,7 was successful, giving a successful pregnancy rate of 87.5%; 4 women delivered their babies safely,3 women had induced abortion. Younger age, higher educational level, having received breast conserving surgery and not having children at the time of cancer diagnosis were associated with stronger childbearing needs. Reasons for not wanting to have children after breast cancer included already having children, single-child policy, fear of disease recurrence, already having recurrence or metastasis and fear of losing fertility after receiving cancer therapies. There were 72(23%) patients in total that received fertility counseling from clinicians after breast cancer diagnosis.Conclusion:This is the first study in which we investigated the childbearing needs, the pregnancy rate and fertility consultations of young breast cancer women after breast cancer diagnosis and treatment using a retrospective, cross-sectional method. In China, the childbearing needs of young breast cancer women after diagnosis and treatment are intense. However, women have various concerns facing the fertility issue. Besides, there is a lack of fertility consultations given by the clinicians. Therefore, the number of women who get fertility preservation and give birth after breast cancer is small. Health care providers should pay close attention to the fertility issues faced by young breast cancer women, actively provide the patients with fertility counseling as soon as the diagnosis is made and offer fertility preservation methods to the patients before and during treatment so that young breast cancer women can have better living quality.