Knowledge, attitudes and practice of physicians towards fertility and pregnancy-related issues in young BRCA-mutated breast cancer patients
Knowledge, attitudes and practice of physicians towards fertility and pregnancy-related issues in young BRCA-mutated breast cancer patients
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DOI：
10.1016/j.rbmo.2018.11.031
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发表时间：
2019-05-01
影响因子：
4
通讯作者：
Demeestere, Isabelle
中科院分区：
文献类型：
--
作者：
Lambertini, Matteo;Di Maio, Massimo;Demeestere, Isabelle
研究问题：本研究探讨了知识，态度和实践的医生对生育和怀孕相关的问题，在年轻的BRCA突变的乳腺癌patients.Design：医生参加两个国际乳腺癌会议完成了26项问卷调查，探讨生育保存，怀孕期间（BCP）或乳腺癌后。进行了统计比较的响应，探索相同的问题，在年轻的乳腺癌患者的整体或具体的BRCA突变。结果：调查完成了273名医生。卵巢组织冷冻保存（33%对40%; P = 0.009）和化疗期间促性腺激素释放激素类似物（74%对81%; P = 0.001）在BRCA突变患者中比在总体乳腺癌人群中更不常见。42%的受访者同意或中立的声明，卵巢刺激不应该被认为是BRCA突变乳腺癌患者的安全。分别有45%和30%的人同意或中立的说法，即乳腺癌幸存者怀孕可能会增加BRCA突变患者或整体乳腺癌人群的复发风险（P < 0.001）。分别有15%和3%的人不同意将冷冻保存的卵巢组织移植到BRCA突变患者或整个乳腺癌人群中是安全的（P < 0.001）。33.3%的人反对在BRCA突变的BCP.Conclusions患者中加入铂类药物作为新辅助化疗：即使在直接参与乳腺癌护理的医生中，对乳腺癌患者的生育能力保护和妊娠相关问题仍存在一些误解。迫切需要集中研究努力解决BRCA突变乳腺癌患者的这些问题，并进行教育以提高医生的知识和遵守现有指南。
Research question: This study explored the knowledge, attitudes and practice of physicians towards fertility and pregnancy-related issues in young BRCA-mutated breast cancer patients.Design: Physicians attending two international breast cancer conferences completed a 26-item questionnaire exploring fertility preservation, pregnancy during (BCP) or after breast cancer. A statistical comparison was carried out of the responses exploring the same issues in young breast cancer patients overall or specifically in those with BRCA mutations.Results: The survey was completed by 273 physicians. Ovarian tissue cryopreservation (33% versus 40%; P = 0.009) and gonadotrophin-releasing hormone analogues during chemotherapy (74% versus 81%; P = 0.001) were less commonly suggested in BRCA-mutated patients than in the overall breast cancer population. 42% of respondents agreed or were neutral on the statement that ovarian stimulation should not be considered safe in BRCA-mutated breast cancer patients. 45% and 30% agreed or were neutral on the statement that pregnancy in breast cancer survivors may increase the risk of recurrence in BRCA-mutated patients or in the overall breast cancer population, respectively (P < 0.001). 15% and 3% disagreed that transplanting the cryopreserved ovarian tissue can be considered safe in BRCA-mutated patients or in the overall breast cancer population, respectively (P < 0.001). 33.3% were against the addition of platinum agents as neoadjuvant chemotherapy in BRCA-mutated patients with BCP.Conclusions: Several misconceptions on fertility preservation and pregnancy-related issues in breast cancer patients persist even among physicians directly involved in breast cancer care. Focused research efforts to address these issues in BRCA-mutated breast cancer patients and education to improve physicians' knowledge and adherence to available guidelines are urgently needed.