Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Sep;6(3):429-434.
doi: 10.1089/jayao.2017.0031. Epub 2017 Jul 7.

Oncology Physicians' Perspectives on Practices and Barriers to Fertility Preservation and the Feasibility of a Prospective Study of Pregnancy After Breast Cancer

Shoshana M Rosenberg  1 , Shari Gelber  2 , Richard D Gelber  2 , Ethan Krop  1 , Larissa A Korde  3 , Olivia Pagani  4 , Ann H Partridge  1
Affiliations

Oncology Physicians' Perspectives on Practices and Barriers to Fertility Preservation and the Feasibility of a Prospective Study of Pregnancy After Breast Cancer

Shoshana M Rosenberg et al. J Adolesc Young Adult Oncol. 2017 Sep.

Abstract

Purpose: POSITIVE (Pregnancy Outcome and Safety of Interrupting Therapy for women with endocrine responsIVE breast cancer) is a prospective clinical trial assessing safety and pregnancy outcomes in premenopausal hormone receptor-positive breast cancer survivors (age ≤42) who interrupt endocrine therapy (ET) to attempt pregnancy. We sought to assess interest in this study and perspectives on fertility preservation (FP) among United States medical oncologists who had previously enrolled women at their institutions on select premenopausal endocrine studies.

Methods: From August 2015 to December 2015, 301 investigators were invited to complete a web-based survey on behalf of their institution. We assessed FP practices and attitudes, barriers to discussing FP, and willingness to open/enroll women on POSITIVE.

Results: Of 93 respondents (31%), most were affiliated with an National Cancer Institute (NCI)-designated comprehensive cancer center (44%). Almost all said they usually or always discussed the issue of future fertility with patients (98%) and referred patients with fertility questions to specialists (97%). Over half of respondents cited discomfort with recommending women to stop ET, as well as perceived patient concern regarding ET interruption, as factors seen as influencing POSITIVE enrollment; however, 84% were willing to recommend trial participation for selected patients.

Conclusions: Most providers reported discussing fertility with their young patients, indicating awareness of FP guidelines for cancer patients. While most oncologists said that they would be willing to recommend POSITIVE, many also expressed discomfort in endorsing women to stop ET temporarily, underscoring the need for prospective data regarding the safety of ET interruption. High willingness to recommend POSITIVE suggests the potential for successful accrual to this study, which addresses a critical issue for young breast cancer survivors.

Keywords: breast cancer; endocrine therapy; fertility; pregnancy.

PubMed Disclaimer

Conflict of interest statement

No competing financial interests exist.

Figures

<b>FIG. 1.</b>
FIG. 1.
Barriers to discussing fertility preservation. *N = 89 respondents, ^N = 88 respondents.
<b>FIG. 2.</b>
FIG. 2.
Attitudes regarding fertility preservation. *N = 91 respondents, ^N = 90 respondents. PGD, preimplantation.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Goldfarb SB, Kamer SA, Oppong BA, et al. . Fertility preservation for the young breast cancer patient. Ann Surg Oncol. 2016;23(5):1530–6 - PMC - PubMed
    1. Ruddy KJ, Gelber SI, Tamimi RM, et al. . Prospective study of fertility concerns and preservation strategies in young women with breast cancer. J Clin Oncol. 2014;32(11):1151–6 - PubMed
    1. Thewes B, Meiser B, Taylor A, et al. . Fertility- and menopause-related information needs of younger women with a diagnosis of early breast cancer. J Clin Oncol. 2005;23(22):5155–65 - PubMed
    1. Llarena NC, Estevez SL, Tucker SL, Jeruss JS. Impact of fertility concerns on tamoxifen initiation and persistence. J Natl Cancer Inst. 2015;107(10) - PMC - PubMed
    1. Gorman JR, Malcarne VL, Roesch SC, et al. . Depressive symptoms among young breast cancer survivors: the importance of reproductive concerns. Breast Cancer Res Treat. 2010;123(2):477–85 - PMC - PubMed