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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