Abstract P5-07-01: Outcomes of multidisciplinary team approach and intensive patient education in young women with breast cancer to improve the rate of fertility preservation

Abstract

Abstract Background Young breast cancer patients of childbearing age often had to give up their opportunity as women or mothers for cancer treatment. As the survival rate of young breast cancer patients increases with advances in early detection and treatment of breast cancer, interest in issues such as fertility preservation, which have not been satisfied so far, is increasing. This study aims to report the experience of improvement of the fertility preservation rate through a multidisciplinary team approach and systematic patient education for young breast cancer patients. Methods Patients treated with multidisciplinary team approach including surgical, medical oncologist and fertility specialist were included for analysis. Patient were divided into two periods: before and after intensive patient education. Patient education included in-person counseling, hand-out materials, and audiovisual education about ovarian dysfunctions related to cancer treatment and fertility preservation methods. We compared the rate of fertility counseling, preservation between two periods. Also, effect of hormonal receptor status on fertility outcome with pregnancy and birth were analyzed. Results The rates of fertility counseling (39.4% to 58.1%), ovarian function preservation with gonadotropin releasing hormone antagonists (37.8% to 49.7%), and either embryo (0.9% to 5.6%) or oocyte preservation (0 to 7.5%) were significantly increased (all, p< 0.001) after intensive patient education. Pregnancy (9.5% vs 14.2%, p=0.034) and birth rate (7.7% vs 12.2%, p=0.043) were significantly higher with women with negative hormone receptor status. In hormone receptor positive patients, similar pregnancy rates were observed (13.3 ~ 15.4%) in patients who complete 5yearsd of endocrine therapy, stopped endocrine therapy due to side effects, and received no endocrine therapy. Patients with any type of recurrence were not pregnant during follow up period. Patients who stopped endocrine therapy for child plan showed highest rate of pregnancy (56.0%). Multivariable analysis revealed intensive education were highly associated with improved fertility outcomes (OR 3.843 95% CI 2.781–5.311, p=< 0.001) after adjusted for different stage and treatment modality. Conclusion Multidisciplinary team approach with intensive patient education of fertility preservation in young women breast cancer significantly improved fertility preservation attempt. Hormonal receptor status and recurrence were associated with impaired fertility outcomes Citation Format: Young Joo Lee, Hayan Han, Hee Jeong Kim. Outcomes of multidisciplinary team approach and intensive patient education in young women with breast cancer to improve the rate of fertility preservation [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P5-07-01.