Abstract PD7-08: Economic and time-related burden in young breast cancer patients wishing to preserve their fertility before undergoing cancer treatment
Authors: Kitano A , Mifune M , Suzuki A , Hashizume A , Nakayama C , Motofuji Y , Suzuki H , Ichioka E 
Published: February 2018

Abstract
Background: Treatment-related infertility is one of many issues facing young breast cancer patients. Fertility preservation, using artificial reproductive therapy (ART), is a recommended method to maintain future reproductive function among cancer patients. However, medical costs for fertility preservation are often too expensive for young cancer patients who can be less economically secure, in addition to the costs of cancer treatment. Moreover, the ART process requires several weeks or more, and time spent in fertility preservation may potentially delay treatment. Pink Ring is a patient advocacy group for young breast cancer patients, established in Japan in 2012, which has been working on the issue of onco-fertility. We conducted a cross sectional web-based survey exploring the economic and time-related burden of young cancer patients in the reproductive age group. This study was supported by a research grant from the Foundation to Promote Cancer Research.
Method: Pink Ring conducted a web-based survey, and 343 young breast cancer patients who responded were enrolled. We performed descriptive analysis of the data.
Result: Among 343 young breast cancer patients, the mean age at the time of the survey was 38 years (20-49) and the mean age at breast cancer diagnosis was 34 years (20-49). At diagnosis, 167 (49%) of the women were married and 171 (50%) were single. At diagnosis, 99 (29%) women had had a child or children and 236 (63%) were childless. Regarding treatment-related infertility, 193 patients (56%) had had discussions with a medical health provider. However, 58 (17%) patients underwent a fertility preservation procedure.
Among patients who underwent fertility preservation, 35 patients (60%) underwent embryo preservation, 23 (40%) underwent oocyte cryopreservation, and 4 (7%) underwent ovarian tissue cryopreservation. According to medical payment for a fertility preservation procedure, 26 patients (45%) paid less than $5000, 21 patients (36%) paid between $5000 and $10000 and 10 patients (17%) paid over $10000. Regarding cost-effectiveness, 51 patients (88%) considered that the medical payment was expensive. According to the duration of the fertility preservation procedure, 7 patients (12%) were treated up to 2 weeks, 8 patients (31%) were treated between 2 and 4 weeks, 21 patients (36%) were treated between 1 and 2 months, and 7 patients (12%) were treated longer than 2 months. Twenty-eight patients (48%) answered that planned cancer treatment was delayed because of a fertility preservation procedure. According to cancer treatment delay, 4 patients (14%) were delayed up to 4 weeks, 14 patients (50%) were delayed between 1 and 2 months, and 10 patients (36%) were delayed longer than 2 months.
Among 285 patients who did not proceed with fertility preservation, the major reasons given for their decision were as follows: lack of awareness regarding treatment-related infertility and fertility preservation options (29%), economic-related burden (25%), and time-related burden (25%).
Discussion: This survey revealed that fertility preservation was a burden not only for economic reasons but also in terms of time required for treatment for young breast cancer patients of reproductive age.
Citation Format: Kitano A, Mifune M, Suzuki A, Hashizume A, Nakayama C, Motofuji Y, Suzuki H, Ichioka E. Economic and time-related burden in young breast cancer patients wishing to preserve their fertility before undergoing cancer treatment [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD7-08.