Non-interventional Study Evaluating Gynecological Impact of Diagnosis and Treatment of Breast Cancer in Patients Younger
Condition: Breast Cancer Female
MeSH terms: Breast Neoplasms
Study type: Observational

Summary: 
      Brest cancer is the most common cancer in women in France with 52.000 new cases diagnosed in
      2010 including nearly 6.000 women younger than 40.

      The improvement of the fertility conservation of cancer patients is one of the goals put
      forward by the french Cancer Plan (Objective 8.1).

      The issue of fertility after a breast cancer is a frequently raised subjects by the concerned
      couples today. The improvement in prognosis due to therapeutic advances combined with the
      increasing age of the first pregnancy and in the recomposed couples bring number of young
      women between 35 and 40 years followed for breast cancer today to raise these questions with
      their oncologists.

      Young women have a greater risk to develop agressive tumors requiring a mulitimodal treatment
      whose general and gonadic side effects can be important and permanently impact the
      reproductive capacity. At the time of diagnosis, almost 50% of these young patients report
      that they want to consider a later pregnancy but no data are available on the evolution of
      this wish over time although it is known that anti-cancer treatments have a serious impact on
      future possibilities of pregnancy(s).

      The sequential chemotherapy regimen prescribed in adjuvant or neo-adjuvant situation includes
      intercaling agents (antracyclines) and an alkylating agent (cyclophosphamide) partially
      responsible for subsequent fertility disorders. In addition, a chemotherapy-induced
      amenorrhea (CAI) occurs in 50 to 80% of women according to the studies, the latter is
      sometines definitive and sequellar of treatment. However, few data describe the time of
      recovery of menstrual cycles in women with CAI and subsequent impact of fertility.

      The aim of this study is to evaluate the impact of cancer diagnosis and treatment on the
      wishes of fertility before and after the management of cancer of the patients in question, on
      the recovery of menstrual cycles and the quality of sexual life of these patients.

      The investigators hope to improve the pre-therapeutic evaluation of women wishing to
      implement measures to preserve fertility, to assist women wishing to consider this type of
      project after cytotoxic treatments and accompany women suffering from a change in self-image
      that has an impact on their quality of life. These results could help to sensitize the
      doctors to the difficulties encountered by young women and to improve and/or to strengthen
      the global and adapted care of these patients.
    

Detailed description: 
      Selection criteria :

        1. Patient with non-metastatic breast cancer ;

        2. Age of patient between 18 and 40 years at histological diagnosis ;

        3. Patient treated with neoadjuvant or adjuvant chemotherapy with or without radiotherapy
           or endocrine therapy ;

        4. Patient who have completed their chemotherapy and/or radiotherapy treatment for at least
           3 months at the time of questionnaire dispatch ;

        5. Patient informed of the study (patient must have received the informed consent document
           and doesn't opposed to it) and who answered to the specific questionnaire of the study ;

      Main objective :

      => Describe the impact of diagnosis and the breast cancer care on fertility in patients
      younger than 40 years.

      Secondary objectives :

        -  Describe the patient population (age, type of histological grade, treatments).

        -  Describe the recovery of menstrual cycle after chemotherapy (occurrence of menstrual
           cycles and regularity).

        -  Describe fertility after treatment.

        -  Describe the sexual impact (adverse events related to diagnosis and therapeutic care)
           through an optional part of questionnaire.

        -  Describe the impact of breast cancer diagnosis on the couple's life.

        -  Describe the impact on body image (body image satisfaction, breast reconstruction).
    

Observational model: Cohort
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        patients aged between 18 and 40 years at the time of diagnosis of non-metastatic breast
        cancer and having completed their radiotherapy and/or chemotherapy treatment(s) for at
        least 3 months
      
Keywords: breast cancer; young women