Childbearing across borders: Fertility and parenthood attitudes and decisions among breast cancer survivors in USA and Portugal

Breast. 2018 Aug;40:16-22. doi: 10.1016/j.breast.2018.04.001. Epub 2018 Apr 16.


Objective: To compare fertility and childbearing attitudes and decisions of Portuguese and American female reproductive aged breast cancer survivors.

Methods: This was a cross-sectional study of 102 young breast cancer survivors (59 from Portugal and 43 from USA). Demographic, clinical and reproductive information were collected. Fertility and parenthood attitudes and decisions were assessed through a self-report questionnaire devised specifically for the study.

Results: Fertility issues became very important after the diagnosis for most of the women (51%). Few differences existed between USA and Portuguese participants. USA participants were more likely to undergo FP (23% USA vs Portugal 5%, p = 0.01). Portuguese women were more dissatisfied with their physician's explanations about fertility (Portugal: 23% vs USA: 3%; p = 0.01). Overall, women relied on their oncologist for fertility information (70%); only Portuguese women discussed fertility with their family medicine physician (11%). Overall, women showed positive attitudes towards motherhood. Portuguese women were more likely to report their partners placed more value on the family after their illness (Portuguese agree: 55% vs USA agree: 14%; p < 0.001).

Conclusions: Fertility and childbearing after breast cancer are important issues regardless of culture, background or country's heath care system. Overall, few differences across the USA and Portuguese samples were found on fertility and childbearing attitudes and decisions.

Keywords: Attitudes; Breast cancer; Childbearing; Fertility; Reproductive age; Survivors.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Breast Neoplasms / ethnology
  • Breast Neoplasms / psychology*
  • Cancer Survivors / psychology*
  • Cross-Sectional Studies
  • Female
  • Fertility
  • Health Knowledge, Attitudes, Practice / ethnology*
  • Humans
  • Portugal
  • Pregnancy
  • Reproductive Behavior / ethnology
  • Reproductive Behavior / psychology*
  • Surveys and Questionnaires
  • United States
  • Young Adult