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Multicenter Study
. 2012 Mar 13;106(6):1053-61.
doi: 10.1038/bjc.2012.61.

Making hard choices easier: a prospective, multicentre study to assess the efficacy of a fertility-related decision aid in young women with early-stage breast cancer

M Peate  1 , B Meiser, B C Cheah, C Saunders, P Butow, B Thewes, R Hart, K-A Phillips, M Hickey, M Friedlander
Affiliations
Multicenter Study

Making hard choices easier: a prospective, multicentre study to assess the efficacy of a fertility-related decision aid in young women with early-stage breast cancer

M Peate et al. Br J Cancer. .

Abstract

Background: Fertility is a priority for many young women with breast cancer. Women need to be informed about interventions to retain fertility before chemotherapy so as to make good quality decisions. This study aimed to prospectively evaluate the efficacy of a fertility-related decision aid (DA).

Methods: A total of 120 newly diagnosed early-stage breast cancer patients from 19 Australian oncology clinics, aged 18-40 years and desired future fertility, were assessed on decisional conflict, knowledge, decision regret, and satisfaction about fertility-related treatment decisions. These were measured at baseline, 1 and 12 months, and were examined using linear mixed effects models.

Results: Compared with usual care, women who received the DA had reduced decisional conflict (β=-1.51; 95%CI: -2.54 to 0.48; P=0.004) and improved knowledge (β=0.09; 95%CI: 0.01-0.16; P=0.02), after adjusting for education, desire for children and baseline uncertainty. The DA was associated with reduced decisional regret at 1 year (β=-3.73; 95%CI: -7.12 to -0.35; P=0.031), after adjusting for education. Women who received the DA were more satisfied with the information received on the impact of cancer treatment on fertility (P<0.001), fertility options (P=0.005), and rated it more helpful (P=0.002), than those who received standard care.

Conclusion: These findings support widespread use of this DA shortly after diagnosis (before chemotherapy) among younger breast cancer patients who have not completed their families.

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Figures

Figure 1
Figure 1
Participant flowchart. Q1, questionnaire one; Q2, questionnaire two; Tx, treatment; *four participants who were allocated to the intervention and five participants to the control did not respond to any questionnaires and have not been included in the statistical anaylses.
Figure 2
Figure 2
Mean DCS scores over the three data collection points.
Figure 3
Figure 3
Change in the percentage of correct answers in the knowledge scale from baseline to 12 months, shown in order of the greatest difference between groups. Key: (1) IVF (in vitro fertilisation) has highest success rate of fertility options (True); (2) some fertility procedures are still experimental and not widely available (true); (3) pregnancy after breast cancer treatment is safe for mother and baby (true); (4) impact of chemotherapy on fertility is not dependent on age (false); (5) IVF will not delay cancer treatment (false); (6) pregnancy after breast cancer treatment will increase chance of recurrence (false); (7) hormonal therapy will not cause infertility except for time spent on treatment (true); (8) many breast cancers depend on hormones to grow – thus some fertility drugs are not recommended (true); (9) fertility treatment can be costly (true); (10) chemotherapy impacts on fertility by depleting eggs in the ovaries (true).
Figure 4
Figure 4
Mean knowledge scale scores over the three data collection points.
See this image and copyright information in PMC

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