Determinants of access to fertility preservation in women with breast cancer

TY - JOUR

T1 - Determinants of access to fertility preservation in women with breast cancer

AU - Lee, Sanghoon

AU - Heytens, Elke

AU - Moy, Fred

AU - Ozkavukcu, Sinan

AU - Oktay, Kutluk

PY - 2011/5

Y1 - 2011/5

N2 - Objective: To evaluate socioeconomic, demographic, and medical factors that influence the referral pattern - either before cancer treatment for fertility preservation (FP, early referral) or post-chemotherapy for assisted reproductive technology (PCART, delayed referral) - in women with breast cancer. Design: Secondary analysis. Setting: Academic medical centers. Patient(s): Three hundred fourteen patients with breast cancer who were counseled for FP (n = 218) or PCART (n = 96) from June 1999 to July 2009. Intervention(s): None. Main Outcome Measure(s): Factors favoring early referrals.Result(s): Mean age at diagnosis was higher in FP vs. PCART (35.3 ± 4.5 years vs. 33.9 ± 4.7 years). Ninety percent presented with cancer stage 1 or 2. From 2000 to 2009 the proportion of referrals for FP increased continually. In 2009, nearly all (95.5%) were for FP. The majority (63.8%) was referred from an academic center. Patients with a family history of breast cancer were more likely to consult for FP (75.2% vs. 64.3% without). There was no association with occupation, income, race, ethnicity, obstetric history, and prior infertility treatment. Only 22.9% of those counseled in PCART, compared with 45.0% in the FP group, proceeded with a procedure.Conclusion(s): There has been an increasing trend within the last 10 years for early referral of breast cancer patients to FP. Factors favoring early referrals are older age, early-stage cancer, family history of breast cancer, and academic center involvement. Those seen before cancer treatment are more likely to receive an intervention.

AB - Objective: To evaluate socioeconomic, demographic, and medical factors that influence the referral pattern - either before cancer treatment for fertility preservation (FP, early referral) or post-chemotherapy for assisted reproductive technology (PCART, delayed referral) - in women with breast cancer. Design: Secondary analysis. Setting: Academic medical centers. Patient(s): Three hundred fourteen patients with breast cancer who were counseled for FP (n = 218) or PCART (n = 96) from June 1999 to July 2009. Intervention(s): None. Main Outcome Measure(s): Factors favoring early referrals.Result(s): Mean age at diagnosis was higher in FP vs. PCART (35.3 ± 4.5 years vs. 33.9 ± 4.7 years). Ninety percent presented with cancer stage 1 or 2. From 2000 to 2009 the proportion of referrals for FP increased continually. In 2009, nearly all (95.5%) were for FP. The majority (63.8%) was referred from an academic center. Patients with a family history of breast cancer were more likely to consult for FP (75.2% vs. 64.3% without). There was no association with occupation, income, race, ethnicity, obstetric history, and prior infertility treatment. Only 22.9% of those counseled in PCART, compared with 45.0% in the FP group, proceeded with a procedure.Conclusion(s): There has been an increasing trend within the last 10 years for early referral of breast cancer patients to FP. Factors favoring early referrals are older age, early-stage cancer, family history of breast cancer, and academic center involvement. Those seen before cancer treatment are more likely to receive an intervention.

KW - access

KW - Breast cancer

KW - chemotherapy

KW - fertility preservation

KW - referral

UR - https://www.scopus.com/pages/publications/79955035362

U2 - 10.1016/j.fertnstert.2011.01.169

DO - 10.1016/j.fertnstert.2011.01.169

M3 - Article

C2 - 21371704

AN - SCOPUS:79955035362

SN - 0015-0282

VL - 95

SP - 1932

EP - 1936

JO - Fertility and Sterility

JF - Fertility and Sterility

IS - 6

ER -