Abstract

Abstract Background: Treatment-related infertility is one of the major concerns of young women with breast cancer. We explored the longitudinal change and factors associated with reproductive concerns of Japanese young women in a prospective cohort study. Method: Women under the age of forty with newly diagnosed, histologically confirmed, operable breast cancer were recruited to “Hope for YBC Project” (UMIN000034481). The participants were asked to respond to anonymous self-written questionnaire regarding reproductive concern, anxiety and depression, perception of motherhood and socio-economic status at baseline and 6M. Result: Among 215 participants who were enrolled in the study, the mean age of 143 participants who responded to both the questionnaire at baseline and 6M was 35.7 (range 25-39): 78 (54.5%) had a university degree or higher, 104 (72.7%) had a partner, 65 (45.5%) had more than one child, and 84 (58.8%) had a household income more than 5 million yen. 57 (39.9%) had desire for having a baby, 37 (25.9%) were unsure and 43 (33.6%) were not interested. Among 143, 33 (23%) attempted fertility preservation. Baseline score of Reproductive Concerns After Cancer scale (RCAC) had weak correlation with the total scores of Hospital Anxiety and Depression Scale (HADS) (r=.397, p< .001) and Decision Conflict Scale (DCS) (r=.365, p< .001), respectively. Perceived “sufficient explanation of the risk of recurrence” and “sufficient explanation of the necessity and benefit of pharmacotherapy” were significantly associated with reduced DCS score at baseline (p< 0.001). The desire for having a baby changed in 15 women (10.5%) at 6M. Although both DCS and HADS significantly lowered at 6M, there was no difference between RCAC score at baseline and at 6M. RCAC score at 6M had correlation with RCAC(r=.793, p< .001), DCS(r=.439, p< .001), and HADS (r=.401, p< .001) scores at baseline. RCAC score at 6M was also associated with younger age (r=.311), non-existence of partner (p=.001), non-existence of child (p=.014), desire for having a baby (p< .001) at baseline, attempt of fertility preservation (p=.025) and not receiving endocrine treatment (p=.047). Conclusion: Reproductive concerns of young women remained throughout the treatment, and concerns at later treatment phase were associated with decision conflict and anxiety at diagnosis. These results shows that young women, especially those who have higher risk of having reproductive concern, need psychological and decision support at diagnosis, including thorough explanation of risk of recurrence and benefit of systemic treatment from oncologists. Citation Format: Chie Watanabe, Hiroko Bando, Akemi Kataoka, Mai Okazaki, Tadahiko Shien, Eriko Tokunaga, Takashi Kuwayama, Chikako Shimizu. Reproductive concerns of Japanese young women with breast cancer: a longitudinal study [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-11-11.

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