Abstract 533P
Background
Prognosis of breast cancer in young population has been significantly improved by the advancement in multimodal treatment. Aside from systemic therapy adverse events, surgery drawbacks on one’s body image and one’s sexual life, treatment-induced endocrine disorders and hypofertility represents another challenge and source of anxiety for young breast cancer survivors.
Methods
This was a retrospective study carried out at the medical oncology department of Farhat Hached University Hospital from January 2019 to April 2024. We included patients aged 39 or less treated for newly diagnosed breast cancer at our department. Data relating to hypofertility discussion and fertility preservation procedures was collected.
Results
Sixty-seven female patients were included. Median age was 35 (23-39). A majority of 71.6% were married, 67.2% of whom had children, 4.5% had a confirmed primary infertility. Treatment was administered with curative intent in 82.1% of cases and with palliative intent in 17.9%. Before chemotherapy initiation, gonadal toxicity was discussed with 41.8% of patients (n=28) , accepted by 44.4% of them (n=12) but only successfully carried out in 41.7% of referred patients (n=5). Main reasons of practician’s omission of FP proposal were palliative setting (25.6% of cases, p=0.009) and patient’s age (71.8% of cases). In fact, patients aged 32 or less were more likely to be offered FP (p<0.0001). Marital status and presence of children didn’t seem to influence the decision for FP proposal (p=0.401 and p=0.258, respectively). Patient’s refusal of FP was mainly their choice (having had enough children in 59.1% of cases, personal preference in 13.6% of cases). Lack of funding laid ground for FP refusal in 22.7% of cases.
Conclusions
In the light of improved survival outcome of young breast cancer patients, we underscore the importance of early discussions about FP before treatment, regardless of marital status or presence of children. Patients should participate actively in the decision concerning their reproductive project.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Medical Oncology Department - Farhat Hached University Hospital, Sousse, Tunisia.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.