年轻乳腺癌患者的生育能力保存：一项关于中国乳房外科医疗保健提供者的知识、态度和实践的全国性调查

IF 5.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Breast Pub Date : 2025-02-18 DOI:10.1016/j.breast.2025.104426

Xiaoling Yuan , Jingdan Li , Nan Zhang , Jiayi Peng , Xiaoran Yang , Wen Li

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引用次数: 0

摘要

目的生殖力保存（FP）是年轻乳腺癌（YBC）患者接受促性腺毒素治疗的关键问题。乳房外科保健提供者（HCPs）在讨论计划生育方案和促进及时转诊方面发挥着关键作用。本研究旨在评估中国乳腺外科HCPs关于计划生育的知识、态度和实践，确定计划生育讨论的障碍，并研究影响转诊实践的因素。方法于2023年3月至6月在全国范围内对执业乳房外科医生和护士进行横断面调查，问卷共24项。参与者通过BestOnco（肿瘤学HCPs的专业平台）通过微信招募。调查评估了计划生育知识、态度、临床实践和感知障碍。进行多变量逻辑回归以确定与计划生育转诊实践相关的因素。结果共分析有效问卷355份。平均计划生育知识得分为6.05±1.94（范围0-10），49.3%的HCPs从未咨询过计划生育指南。虽然82.8%的人对计划生育持赞成态度，但只有42.3%的人定期讨论计划生育方案，44.7%的人将患者转介给生殖专家。主要障碍包括预后不良（87.0%）、治疗紧急（67.9%）和经济负担（60.0%）。多因素分析显示，较高的FP知识(OR = 1.23, p <；0.0001)、较长的临床经验（OR = 2.93, p = 0.001）和基于医院的计划生育整合(OR = 1.83, p <；0.0001)是转诊的显著预测因子。结论中国乳腺外科HCPs在计划生育知识、讨论和转诊方面存在明显差距。建议有针对性的计划生育培训项目、文化信息共享的决策策略和肿瘤生育导航系统来加强计划生育服务的提供和改善患者的治疗效果。

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Fertility preservation in young breast cancer patients: A nationwide survey on knowledge, attitudes, and practices among breast surgical healthcare providers in China

Purpose

Fertility preservation (FP) is a critical concern for young breast cancer (YBC) patients receiving gonadotoxic treatments. Breast surgical healthcare providers (HCPs) play a pivotal role in discussing FP options and facilitating timely referrals. This study aimed to assess the knowledge, attitudes, and practices of breast surgical HCPs in China regarding FP, identify barriers to FP discussions, and examine factors influencing referral practices.

Methods

A nationwide cross-sectional survey was conducted from March to June 2023 among board-certified breast surgeons and nurses across China using a 24-item questionnaire. Participants were recruited via WeChat through BestOnco, a professional platform for oncology HCPs. The survey assessed FP knowledge, attitudes, clinical practices, and perceived barriers. Multivariate logistic regression was performed to determine factors associated with FP referral practices.

Results

A total of 355 valid responses were analyzed. The mean FP knowledge score was 6.05 ± 1.94 (range 0–10), with 49.3 % of HCPs never consulting FP guidelines. While 82.8 % expressed a favorable attitude toward FP, only 42.3 % routinely discussed FP options, and 44.7 % referred patients to reproductive specialists. Major barriers included poor prognosis concerns (87.0 %), treatment urgency (67.9 %), and financial burden (60.0 %). Multivariate analysis revealed that higher FP knowledge (OR = 1.23, p < 0.0001), longer clinical experience (OR = 2.93, p = 0.001), and hospital-based FP integration (OR = 1.83, p < 0.0001) were significant predictors of referral.

Conclusions

Notable gaps were identified in FP knowledge, discussions, and referrals among breast surgical HCPs in China. Targeted FP training programs, culturally informed shared decision-making strategies, and oncofertility navigation systems are recommended to enhance FP service delivery and improve patient outcomes.

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来源期刊

Breast 医学-妇产科学

CiteScore

8.70

自引率

2.60%

发文量

165

审稿时长

59 days

期刊介绍： The Breast is an international, multidisciplinary journal for researchers and clinicians, which focuses on translational and clinical research for the advancement of breast cancer prevention, diagnosis and treatment of all stages.