Oncocontraception in breast cancer care.

Abstract

e19679 Background: Based on a case series of patients, the need for providers to address pregnancy as it relates to the diagnosis of breast cancer was realized. Equally as important as the emphasis on intended pregnancy is the prevention of unintended pregnancy during cancer treatment. Thus, the growing interest in oncofertility calls for a developed algorithm for reproductive health management. The objective was to incorporate and investigate the implementation of a reproductive health assessment tool in breast cancer care for women of childbearing age (18-55) and to study outcome measures to determine the tool effectiveness. Methods: This prospective observational study was executed by providing training on reproductive health in the context of cancer care for oncology staff in the breast cancer clinic. Referral lines for various components of reproductive health care were developed. The reproductive health algorithm was developed for each patient according to their reproductive goals. Women with newly diagnosed with breast cancer were eligible for this study. Eleven patients were enrolled and will continue to be followed through the end of the study. We are in the second of a three year study. Baseline surveys, lab data and subsequent treatment plans were recorded and implemented. Results: All participants received contraception/family planning counseling. Before study entry, only 4 out of 11 (36%) women presented with long-term contraception (LTC). Of the 7 others, 2 had become pregnant post-diagnosis, 1 had a miscarriage days prior to diagnosis, 2 were abstinent, and 2 used condoms. Eight of 11 (73%) had completed childbearing at study entry. After algorithm implementation, LTC use increased to 64% (n = 7). Four (36%) used Paraguard IUD and 3 (27%) had permanent sterilizations. The others used abstinence (n = 3, 27%) and one used condoms (9%). Women who completed childbearing increased to ten (91%). Fertility preservation counseling referral was made for the woman interested in future childbearing. Conclusions: The reproductive health algorithm allows patients to gain perspective of their reproductive goals in light of their diagnosis, enhancing options for management of those goals, minimizing unintended pregnancies, and increasing efficiency of cancer treatment. No significant financial relationships to disclose.