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William J. Gradishar, MD, FACP, FASCO
William J. Gradishar, MD, FACP, FASCO
Posted: Wednesday, January 11, 2023
In a cohort study of 2,900 premenopausal women with early-stage breast cancer, published in JAMA Network Open, researchers examined the chosen methods and factors associated with the use of contraception. Matteo Lambertini, MD, PhD, of the IRCCS Ospedale Policlinico San Martino and the University of Genoa, Italy, and colleagues commented: “As life span has increased among patients with cancer, survivorship has become an important component of breast cancer care. Among survivorship concerns, adequate contraceptive counseling is needed for premenopausal patients who are not seeking to become pregnant.”
At the time of analysis, 9,595 patients with breast cancer—among 12,012 total participants—were enrolled in the CANTO study from 2012 to 2017. Follow-up was available until the second post treatment visit (year 2).
A total of 2,900 premenopausal patients with early-stage breast cancer were included in the analysis; 2,050 of 2,894 women (70.8 %) received chemotherapy, and 2,305 of 2,880 women (80.0 %) received endocrine therapy. After diagnosis, 1,182 of 2,625 patients (45.0 %) at year 1 and 1,553 of 2,363 patients (65.7 %) at year 2 reported consulting with a gynecologist in the previous year. At diagnosis, 1,487 of 2,744 patients (54.2 %) reported contraceptive use, with many patients (921 of 1,470 women [62.7 %]) using hormonal methods.
The use of contraception significantly decreased after diagnosis (911 of 2,342 patients [38.9 %] at year 1 and 808 of 1,961 patients [41.2%] at year 2) when most patients (848 of 900 women [94.2 %] at year 1 and 767 of 805 women [95.3 %] at year 2) reported use of nonhormonal methods; these methods were primarily reversible mechanical approaches. In the multivariable model, factors significantly associated with contraceptive use at year 1 included using contraception at diagnosis, having better sexual function, having children, reporting the presence of leukorrhea, receiving tamoxifen treatment alone, and consulting with a gynecologist in the previous year. At year 2, similar factors were associated with contraceptive use, with the addition of partnered status.
Disclosure: The study authors reported no conflicts of interest.
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