Abstract PO5-11-05: Fertility, sexuality and other unmet needs of young breast cancer survivor during and at the end of treatment in France: a national qualitative study by the French Network of Cancer Registries (FRANCIM)
Authors: Assogba Emerline , Dumas Agnès , Morgny Cynthia , Borel Myriam , Brun Véronique , Meunier-Beillard Nicolas Nicolas , Mamguem Ariane , Coutant Charles , Desmoulins Isabelle , Dabakuyo Sandrine 
Published: May 2024

Abstract
Introduction In recent decades, the living conditions of breast cancer (BC) survivors have received particular attention, especially among the youngest who face problems related to fertility and sexuality. Integrating women's needs into medical decisions is becoming increasingly essential for high-quality care. This study aimed to describe and understand the experiences of young women after BC, examined the scope and content of information transmitted on fertility and sexuality during routine appointments during the management of BC, and identify unmet support needs. Methods This study follows on from a quantitative study using self-questionnaires, in which patients met the following inclusion criteria (Non-metastatic invasive BC women diagnosed from 2009 to 2016, aged ≤ 40 years at diagnosis were identified through the FRANCIM Network). Interviews were conducted with a sample of 29 women drawn at random from among eligible women who completed the self-questionnaires in the quantitative study. The sample were stratified by age, department, socio-professional category and socio-economic level. Individual face-to-face semi-structured interviews were conducted either by videoconference or face-to-face, in patient's homes or in any other location of their choice during October to December 2022. The interviews were audio-recorded, transcribed verbatim, and analyzed thematically. Results Findings revealed that during treatments, women would like physicians (oncologists, surgeons, radiologists, gynecologist, etc.) to be more empathetic, more humane, and show tact and attentiveness when announcing the disease and treatments during the course of care. They would like to be better informed about the post-treatment side effects and better prepared by the physicians, for the feeling of abandonment felt in the aftermath of cancer due to the absence of medical appointments. The mains unmet needs of BC survivors were more numerous at the end of the treatments. In fact they more deplore the lack of coverage and reimbursement of aesthetic care and paramedical care essential to women to compensate for the persistent side effects and the repercussions of the disease and post-cancer treatments (eg: a more aesthetic and better reimbursed breast reconstruction at the end of the treatments, support by psychologists, etc.). With regard to sexuality, in the absence of systematic information for patients on the side effects of treatments on sexuality at diagnosis, it would be desirable to ask the woman if she would like to be informed. In addition, psychological support for the couple during and after treatment in terms of sexuality is necessary to avoid divorce and separation. In terms of fertility, there is a lack of systematic information for young women on the side effects of treatment on fertility, as well as questioning by physicians about any pregnancy plans women may have at the time of diagnosis. The introduction of fertility preservation with the possibility of it being systematically offered to all young women at diagnosis is important (or, failing that, the subject should be discussed more with the women), as it represents a gap in support). For women who had a pregnancy plan at diagnosis, the majority felt a lack of listening by doctors and adaptation of care to their pregnancy plan at diagnosis. Conclusions This study showed that, despite the high quality of care provided to young women diagnosed with BC in France, they felt they had unmet needs in terms of sexuality, fertility and access to paramedical care at the end of treatment. Indeed, these women face psychological suffering that they would like physicians to see beyond their physical suffering based on their experience. The results of this study could help public authorities and physicians improve care and life after cancer for young women diagnosed with BC.
Citation Format: Emerline Assogba, Agnès Dumas, Cynthia Morgny, Myriam Borel, Véronique Brun, Nicolas Nicolas Meunier-Beillard, Ariane Mamguem, Charles Coutant, Isabelle Desmoulins, Sandrine Dabakuyo. Fertility, sexuality and other unmet needs of young breast cancer survivor during and at the end of treatment in France: a national qualitative study by the French Network of Cancer Registries (FRANCIM) [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-11-05.