Lessons Learned from the Integration of Reproductive Health Specialists in the Multidisciplinary Care of Women with Locally Advanced Breast Cancers
Recommended Citation
Miller M, Bensenhaver J, Cannella C, Petersen L, Swain M. Lessons Learned from the Integration of Reproductive Health Specialists in the Multidisciplinary Care of Women with Locally Advanced Breast Cancers. Obstet Gynecol 2023; 141(5):92S.
Document Type
Conference Proceeding
Publication Date
5-1-2023
Publication Title
Obstet Gynecol
Abstract
INTRODUCTION: The objective of this study was to investigate whether a multidisciplinary approach to breast cancer care with the inclusion of a reproductive health specialist improves referral rates for fertility counseling and/or preservation. METHODS: An IRB-approved retrospective study including women of reproductive age diagnosed with locally advanced breast cancer and treated at a health system before and after the advent of a comprehensive, multidisciplinary tumor board (cMTB) with a reproductive health specialist was conducted. Rates of referral for fertility counseling and utilization of fertility preservation methods were compared between the cMTB and non-cMTB groups using t tests. Secondary analyses comparing baseline group characteristics and rates of referral/fertility preservation by age, insurance type, and race were performed using x2 tests. RESULTS: Of 306 study participants, 117 were cared for by a non-cMTB and 189 by a cMTB. The groups did not differ in average age, parity, breast cancer subtype, insurance type (public versus private), or treatment site (urban versus suburban); however, the distribution of race was significantly different (P 5.003). Overall, a greater percentage of women in the cMTB group received referrals for fertility counseling compared to those in the non-cMTB group (23.3% versus 0.9%, P,.001). Of the patients in the cMTB group who were referred for counseling, 20.5% underwent fertility preservation. Within the cMTB group, women younger than 30 were significantly more likely to be referred for fertility counseling (41.7% versus 20.6%, P 5.043) and undergo a fertility preservation procedure (16.7% versus 3.0%, P 5.016) than those aged 31-40. No significant differences in rates of referral or fertility preservation by race or insurance type were noted within each group. CONCLUSION: The inclusion of a reproductive health specialist in a multidisciplinary breast cancer tumor board increased rates of referral for fertility counseling for women of reproductive age. A similar, comprehensive approach to the care of reproductive-aged women with gynecologic malignancies should be considered.
Volume
141
Issue
5
First Page
92S