Risk-benefit perception of pregnancy among breast cancer survivors

Abstract

Helping breast cancer patients who desire a pregnancy after cancer treatment is a vital issue. Little is known about the complex context of the decision to become pregnant after breast cancer treatment. The purpose of this study was to understand the risk-benefit perception of choosing conception or contraception after treatment in Taiwan. We applied grounded theory to guide this exploratory qualitative study. Data were collected through in-depth interviews with 16 breast cancer patients. Pregnancy was addressed in the context of cancer as a potentially life-threatening diagnosis and its treatment. The verbatim transcriptions were analysed using constant comparative analysis and methods of open, axial and selective coding. The core theme that described the risk perception of pregnancy among patients with breast cancer after treatment focused on "reaching the balance of life." Seven dimensions of risk-benefit perception of pregnancy, including perceived health status, safety, expected gain, harm, loading, support and time were explored among women treated for breast cancer. We found that women treated for breast cancer applied risk-benefit perceptions to decide whether to become pregnant. Implementing contextual counselling could help to decrease perceived barriers to choose pregnancy and increase the quality of pregnancy care.

Threatened fertility: A longitudinal study exploring experiences of fertility and having children after cancer treatment

“…Similarly, women's efforts to balance the risks and benefits of a future pregnancy have been described in a recent study among 16 breast cancer survivors in Taiwan (Hsieh et al, 2017). Similarly, women's efforts to balance the risks and benefits of a future pregnancy have been described in a recent study among 16 breast cancer survivors in Taiwan (Hsieh et al, 2017).…”

“…to worry about health problems in connection with a pregnancy (Gorman, Bailey, Pierce, & Su, 2012), the health of the future child (Gorman et al, 2012;Nilsson et al, 2014), increased risk of recurrence due to pregnancy (Hsieh et al, 2017) and about leaving a child motherless (Kirkman et al, 2014). While there is no evidence of any overall increased risks of recurrence due to pregnancy or of genetic disorders and congenital defects among offspring of cancer survivors, worries about possible pregnancy problems may be well founded (Lawrenz et al, 2012).…”

“…A study among 484 male and female cancer survivors showed that parental status and age were associated with a change in the desire to have children (Armuand, Wettergren, Rodriguez-Wallberg, & Lampic, 2014). Qualitative research has provided valuable insight into male and female survivors' experiences of compromised fertility (Perz, Ussher, & Gilbert, 2014;Wong et al, 2017) and the complexity involved in the decision to have children following cancer (Hsieh et al, 2017). Qualitative research has provided valuable insight into male and female survivors' experiences of compromised fertility (Perz, Ussher, & Gilbert, 2014;Wong et al, 2017) and the complexity involved in the decision to have children following cancer (Hsieh et al, 2017).…”

Infertility‐related knowledge in childbearing‐age women with breast cancer after chemotherapy

“…This finding contrasts with a study that reported more than one in four women were interested in having children after treatment, and women were delighted when pregnancies occurred (Gonçalves, Sehovic, & Quinn, ). Explanations of this difference might be associated with the lower total fertility rate of the population (0.9‐1.3) in Taiwan (Ministry of Health and Welfare, Taiwan, ), fear of cancer relapse (Gonçalves et al, ), worry about future child's health (Gonçalves et al, ; Hsieh et al, ), the costs of fertility treatment, and raising children (Nachtigall, MacDougall, Davis, & Beyene, ; Schmidt et al, ). It is possible that women with breast cancer in Taiwan have a more negative psychological outlook toward fertility than their peers in western countries.…”

Opportunities for personalised follow‐up care among patients with breast cancer: A scoping review to identify preference‐sensitive decisions

“…Getting pregnant after breast cancer (Benedict et al, 2017;Corney & Swinglehurst, 2014;Gorman et al, 2011;Hsieh & Huang, 2017). 0) Getting pregnant after cancer treatment.…”