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Family ties: young breast cancer patients and their children
Uwe Güth1, Dorothy Jane Huang2, Judith Alder3
1Cantonal Hospital Winterthur, Department of Gynaecology and Obstetrics, Breast Centre "Senosuisse", Winterthur; University Hospital Basel (UHB), Women's Hospital, Division for Gynaecology and Gynaecological Oncology, Basel.
Insights
Young breast cancer patients often forgo endocrine therapy to preserve fertility. Children of mothers with breast cancer require specialized support throughout the disease trajectory.
Area of Science:
- Oncology
- Reproductive Health
- Pediatric Psychology
Background:
- Young breast cancer patients (≤40 years) face unique challenges impacting treatment decisions.
- Family ties and fertility desires significantly influence treatment adherence in this demographic.
Purpose of the Study:
- To assess the role of family ties, specifically having children, on treatment compliance in young breast cancer patients.
- To understand the impact of breast cancer on children and the implications for their support.
Main Methods:
- Analysis of a consecutive cohort of 100 breast cancer patients diagnosed at age ≤40, using the Basel Breast Cancer Database.
- Evaluation of compliance with adjuvant chemotherapy and endocrine therapy in relation to parity and fertility desires.
Main Results:
- Patients with children showed higher compliance with endocrine therapy (p=0.021).
- 41.2% of patients with children discontinued endocrine therapy to pursue pregnancy.
- 37 patients (children) experienced their mother's palliative care and death, averaging 84.7 months of exposure to the illness.
Conclusions:
- Fertility desires strongly influence young women's decisions to refuse or discontinue endocrine therapy.
- A significant proportion of children experience their mother's advanced cancer and death, necessitating age-appropriate psychosocial support.
- Healthcare providers must address the immense pressure young women face regarding fertility and provide comprehensive support for their children.
Background:
This study assessed the interaction of "family ties" in a cohort of young breast cancer patients.
Methods:
Based on the Basel Breast Cancer Database, we analysed an unselected, consecutive cohort of patients who were ≤40 years at breast cancer diagnosis (n = 100).
Results:
Sixty patients had children at the time of diagnosis (mean number of children: 1.03). Only four patients had desired children after BC therapy. The average age of the children at breast cancer diagnosis of their mother was 7.7 years. The mean age of the children whose mothers died of breast cancer at the time of their mother's death was 13.1 years; these children (n = 37) lived an average of 84.7 months with the illness of their mother. Parity status was not a significant factor for compliance/persistence to adjuvant chemotherapy (p = 1.00). Patients who had children were more likely to be compliant/persistent to endocrine therapy (p = 0.021). Out of these patients, 41.2% rejected or discontinued endocrine therapy with the explicit intention to get pregnant.
Conclusions:
Desire for children was an important factor in refusing endocrine therapy. This clearly highlights the enormous pressure that many young women face in this situation. About a third of the children whose mothers were diagnosed with breast cancer experienced the palliative situation and the death of their mother. Since many of these children are confronted with a cancerous disease of their mothers during half of their childhood, special attention should be paid to age-appropriate support of a child in all phases of the mother's disease.
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