Reviewer’ s report
Title: Contraceptive needs and fertility intentions of women with breast cancer in Cape Town,
South Africa: a qualitative study
Version: 1Date: 22 Aug 2020
Reviewer's report:
The manuscript reports clearly on a study filling an important evidence need about serving the
reproductive health needs of women undergoing breast cancer treatment in South Africa.
The following are points for the authors to consider as they finalize the paper for publication:Lines 107-108: Clarify the wording. I wasn't certain why delays in starting systemic treatment due
to ovarian stimulation would be more significant in poorer resourced health settings. Is it becausefirst there could be delays in getting the ovarian stimulation services? Please explain this a littlefurther.
Lines 133-134: Describe the population typically served by this large tertiary public sector
hospital. For example, does the hospital typically serve poorer, under-served people? Or is apublic sector facility the predominant model of tertiary care hospital in South Africa? It would behelpful to give some indication of the generalizability of the findings (even though this study wasnot intended to be representative).
Lines 143-148: Can you say more about recruitment? How did the breast cancer clinics staff
decide which patients should be contacted for potential participation? Is any information available
about the refusal rate? Is it possible that women currently using contraception would be more apt
to participate in the study?
Line 169: "Key areas explored included…" Do the areas that follow pertain to the interviews with
patients?
Lines 204-205: Was information collected on whether the woman was currently sexually active?Line 470: The discussion suggests that with effective counseling patients could be directed to the
appropriate referral pathway. Is it safe to assume that these pathways will be smooth, and womenreferred for contraceptive services will have those needs reliably filled?
Lines 470-473: There is no mention in the paper about women who get diagnosed with breast
cancer when they are already pregnant. Although studying this situation is likely beyond thescope of the paper, it seems to be another reproductive health scenario faced by oncologists.Consider mentioning this as another issue that could be included in provider training.
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YesDeclaration of competing interests
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(default)
Is the study design appropriate to answer the research question (including the use of appropriate
controls), and are the conclusions supported by the evidence presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?YesIs the use of statistics and treatment of uncertainties appropriate?YesIs the presentation of the work clear?YesAre the images in this manuscript (including electrophoretic gels and blots) free from apparent
manipulation?
Yes