Awareness, attitude and practice of contraception among females with Breast cancer: A Hospital based survey

Breast cancer is the most frequent cancer among females worldwide as per Globocan 2022. Approx. 645000 premenopausal breast cancer cases were diagnosed worldwide in 2018 which constitute 30.9% of total breast cancer cases.With increasing incidence and survival rates survivorship issues including motherhood and contraception, are increasingly being encountered in routine practice.Several studies that suggest increased rates of therapeutic abortion in any cancer survivor/patient in reproductive age group.Unintended pregnancy risk need to be shorten and ensure that they are planned when they are truly willing and in better health to bear pregnancy.

Many a times less time is allotted to discuss regarding issues related to pregnancy and contraception. After diagnosis of cancer, psychological issues and other factors, female doesn’t want pregnancy. In a study based in France on 517 Breast cancer patients 15% pregnancies were unplanned and they found that these patients were less likely to have received fertility counseling (p=0.02) and contraceptive counseling (p=0.08) at the time of diagnosis. Multiple studies done internationally are suggestive of suboptimal counselling related to contraception.Thus there is high demand of effective and safe contraceptive method as well as counselling.There are multiple methods in use by general population with their advantages and disadvantages and also marked differences in efficacy during typical use. But there are limited guidelines by family planning societies on contraceptive use in cancer survivors and also they are not cancer specific. Which method is safest and easy to be used in this group is a big question/dilemma.Hormonal contraception is not indicated in such patients due to risk of thromboembolism and as it is itself predicted as risk factor for carcinoma breast. Behavioral and barrier methods have low efficacy. Depot medroxyprogesterone acetate is not recommended for patients with osteoporosis. In these women, the copper intrauterine device (IUD) seems to be a good choice. Schwarz et al also recommended the Copper T380A intrauterine device (IUD) as a highly effective, reversible, long-acting, hormone-free method for cancer survivors

In India permanent method of contraception especially female sterilization is widely employed method with statistics suggesting that 37% of women in India aged between 15 and 49 are sterilized. But sterilization rate in breast cancer patients is not known in India. To the best of our knowledge no Indian data is available regarding contraceptive counseling as well as usage. Thus, we conducted this cross-sectional study in regional cancer center to know the awareness, attitude and most commonly utilized method. Contraceptive counseling present status will be assessed.

If we know about the particular Patients’ need family planning methods/contraceptive counseling can be promoted accordingly. Contraceptive clinic reference can be done in timely manner and risk of unwanted pregnancies can be prevented.The aim is to assess the knowledge and attitude towards contraception and current utilization practices so as to fill up the lacunae in current contraceptive counselling.