"My choice": breast cancer patients recollect doctors fertility preservation recommendations

Support Care Cancer. 2017 Aug;25(8):2421-2428. doi: 10.1007/s00520-017-3648-1. Epub 2017 Feb 25.


Purpose: The increasing rates of early-onset breast cancer (BC) and of woman survival render fertility preservation (FP) a pressing issue. We probe women's experiences of FP counseling and decision making, aiming to identify emergent counseling patterns.

Methods: Semi-structured interviews were conducted with 16 women, who had been diagnosed with BC at the ages of 24-38, 1 to 5 years prior to the interview. BC survivors were recruited through posts in online fora, consented to participate, and were invited to tell their FP stories. The transcribed interviews were analyzed thematically, using the phenomenological paradigm.

Findings: Doctors' FP recommendations belong into three categories: (a) direct clinical rationale-grounding recommendations in the woman's clinical condition by direct reference to tumor characteristics and prognosis, (b) indirect clinical rationale-reference to the woman's clinical condition by outlining a pressing time-frame, and (c) sociodemographic rationale-focus on the woman's family status. Women's responses revealed primarily detachment and compliance alongside initiative and proactivism.

Conclusion and implications for cancer survivors: Beyond its contribution to women's future ability to conceive, FP may constitute an arena of personal autonomy and a coping resource for young BC patients. Raising awareness to this significance may sensitize healthcare providers to the role that FP may play in the moment of cancer diagnosis in adding, alongside sickness and prognosis, a focus on family future planning. As such, FP may affect women's quality of life and even survival.

Keywords: Cryopreservation; Early onset breast cancer; Fertility; Fertility preservation.

MeSH terms

  • Adult
  • Breast Neoplasms / pathology
  • Breast Neoplasms / psychology*
  • Choice Behavior / ethics*
  • Female
  • Fertility Preservation / psychology*
  • Humans
  • Quality of Life / psychology*