Abstract PD6-04: HOHO study: How European and US young women cope with breast cancer and fertility concerns
Authors: Pagani O , Bagnardi V , Ruggeri M , Bianco N , Gallerani E , Buser K , Giordano M , Gianni L , Rabaglio M , Freschi A , Cretella E , Clerico M , Amadori D , Simoncini E , Ciccarese M , Rauch D , Glaus A , Berardi R , Franzetti A , Ruddy KJ , Gelber S , Partridge AH , Colleoni M 
Published: March 2017

Background

The International Breast Cancer Study Group (IBCSG), in collaboration with Dana-Farber Cancer Institute, conducts the European (EU) cohort of the Helping Ourselves Helping Others (HOHO) study. HOHO is a prospective longitudinal cohort study investigating short and long-term treatment and fertility concerns in young women with breast cancer (BC): most previous studies have been retrospective.

Patients and methods

From Aug 2009-Jan 2016, 300 patients aged 18-40 yrs with early/advanced BC were enrolled within 6 mos of diagnosis in 18 Centers in Italy and Switzerland. Patients are surveyed every 6 mos the first 3 yrs and yearly for additional 7 yrs. 297 baseline surveys were evaluable. The baseline survey includes sociodemographic and treatment data, and a modified Fertility Issues Survey (including fertility concerns, preservation, outcome and impact on treatment decisions). Clinical data are collected yearly. We qualitatively compare the EU baseline data with the published US data (Ruddy et al, JCO 32:1151, 2014).

Results

Almost two thirds of women in both cohorts discussed future fertility with their doctors at diagnosis. Fertility concerns, desire for future pregnancy (both before disease onset and at time of survey) and steps to reduce infertility were all more common in the EU cohort. EU women were also more concerned about fertility when discussing treatment and about a possible relapse affecting their ability to care for future children.

Conclusion

Many young women with newly diagnosed BC have concerns about fertility, which may affect their treatment decisions. In the EU cohort fewer women had a stable relationship and children before diagnosis, potentially influencing their treatment decisions and encouraging fertility preservation. Concerns about a possible relapse could partly explain the decrease in their pregnancy desire after the disease. Differences between EU and US women seem to emerge: continued data collection will determine if they persist over time. The POSITIVE Trial (IBCSG 48-14/ALLIANCE 221405) will address safety and outcome of pregnancy after BC.

USEUN (%)N (%)620 (100)297 (100)Age &lt;35 yrs229 (37)95 (32)Married or in a significant relationship474 (76)192 (65)Had children before BC diagnosis409 (66)160 (54)Never pregnant158 (25)119 (40)Before BC wished to have future children230 (37)161 (54)At time of survey wished to have future children160 (26)120 (40)If wanted more children, concerned about: (some women indicated more than one)n=160n=120Caring for them if BC recurred27 (17)45 (38)Children having increased risk of developing cancer70 (44)38 (32)Pregnancy would increase risk of recurrence-56 (47)Reason(s) for not wanting more children: (some women indicated more than one)n=460n=177Caring for them if BC recurred18 (4)28 (16)Children having increased risk of developing cancer33 (7)22 (12)Pregnancy would increase risk of recurrence59 (13)16 (9)Concerned about fertility at time of treatment decision-making (a little, somewhat or a lot)319 (51)189 (64)Fertility concerns affected treatment decision (a little, somewhat or a lot)160 (26)115 (39)Took special steps to decrease infertility65 (10)79 (27)Discussed fertility issues with physician before starting therapy424 (68)198 (67)

Citation Format: Pagani O, Bagnardi V, Ruggeri M, Bianco N, Gallerani E, Buser K, Giordano M, Gianni L, Rabaglio M, Freschi A, Cretella E, Clerico M, Amadori D, Simoncini E, Ciccarese M, Rauch D, Glaus A, Berardi R, Franzetti A, Ruddy KJ, Gelber S, Partridge AH, Colleoni M. HOHO study: How European and US young women cope with breast cancer and fertility concerns [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr PD6-04.