8P - Knowledge, practice and attitudes of physicians in low- and middle-income countries (LMIC) on fertility and pregnancy-related issues in young breast cancer patients

Background

Fertility and pregnancy-related issues are a priority area of concern for young breast cancer (BC) patients (pts). Limited evidence exists on knowledge, practice and attitudes of physicians practicingin low- and middle-income countries (LMIC)towards these issues.

Methods

A 19-item questionnaire adapted from an international survey (Lambertini et al, Breast 2018) exploring issuesaboutfertility preservation and pregnancy after BCwas sent by email to physicians from LMIC involved in BC care.Descriptive analyses were performed.

Results

A total of 288 physicians completed the survey. Median age was 38 years (interquartile range 33-45).Respondents from Asia, Africa, America and Europe filled in the survey: the 3 most represented countries were Mexico (27.1%), India (18.4%) and Brazil (8.3%).The majority of respondents were medical oncologists (44.4%)working in an academic setting (46.9%). Among respondents, 40.2% and 53.8% reported never having consulted the available international guidelines on fertility preservation and pregnancy after BC, respectively. 25.0%, 19.1% and 24.3% of respondents declared to be not at all knowledgeable about embryo, oocyte or ovarian tissue cryopreservation, respectively. 29.2%, 23.6% and 31.3% declared that embryo, oocyte and ovarian tissue cryopreservation are not available in their countries, respectively. 57.6% of respondents disagreed or were neutral on the statement that controlled ovarian stimulation (COS) can be considered safe in BC pts; 29.9%suggested that COS should not be considered safe in pts with hormone receptor-positive (HR+) disease. 49.7% and 58.6% of respondents agreed or were neutral on the statement that pregnancy in BC survivors may increase the risk of recurrence overall or only in those with HR+ disease, respectively. In contrast, 49.0% agreed that COS in BC survivors can be safely considered.

Conclusions

Several misconceptions exist among physicians from LMIC on fertility and pregnancy-related issues in young BC pts. Increased awareness and further educational initiatives are needed to improve adherence to available guidelines and pts’oncofertility counseling.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

N.F. Ponde: Advisory/Consultancy: Lilly; Honoraria (self): Roche,Novartis, AstraZeneca and Lilly. M. Brandão: Honoraria (self), Travel/Accommodation/Expenses: Roche/GNE. I.B. Spasojevic: Advisory/Consultancy: Roche, Novartis, Amicus; Honoraria (self): Roche, Novartis, Pfizer, AstraZeneca. A. Odhiambo: Honoraria (self), Travel/Accommodation/Expenses: AstraZeneca, Roche, Novartis; Advisory/Consultancy: Pfizer, AstraZeneca, Janssen. M. Tagliamento: Travel/Accommodation/Expenses: Roche, Bristol-Myers Squibb, AstraZeneca, Takeda; Full/Part-time employment, Medical Writer: Novartis, Amgen. M. Lambertini: Advisory/Consultancy: Roche, Novartis; Honoraria (self): Roche, Takeda, Theramex, Novartis, Pfizer, Lilly. All other authors have declared no conflicts of interest.