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Exploring the facilitators and barriers to using an online infertility risk prediction tool (FoRECAsT) for young women with breast cancer: a qualitative study protocol
  1. Zobaida Edib1,2,
  2. Yasmin Jayasinghe1,2,3,
  3. Martha Hickey1,2,
  4. Lesley Stafford4,5,
  5. Richard A Anderson6,
  6. H. Irene Su7,
  7. Kate Stern8,9,
  8. Christobel Saunders10,
  9. Antoinette Anazodo11,12,
  10. Mary Macheras-Magias13,
  11. Shanton Chang14,
  12. Patrick Pang14,
  13. Franca Agresta8,9,
  14. Laura Chin-Lenn15,
  15. Wanyuan Cui16,
  16. Sarah Pratt17,
  17. Alex Gorelik18,19,
  18. Michelle Peate1,2
  1. 1 Obstetrics & Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia
  2. 2 Obstetrics & Gynaecology, The Royal Women's Hospital, Parkville, Victoria, Australia
  3. 3 Department of Paediatric and Adolescent Gynaecology, The Royal Children's Hospital, Parkville, Victoria, Australia
  4. 4 Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
  5. 5 Centre for Women’s Mental Health, The Royal Women's Hospital, Parkville, Victoria, Australia
  6. 6 MRC Centre for Reproductive Health, The University of Edinburgh, Edinburgh, Edinburgh, UK
  7. 7 Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, San Diego, California, USA
  8. 8 Melbourne IVF, East Melbourne, Victoria, Australia
  9. 9 Reproductive Services, The Royal Women's Hospital, Parkville, Victoria, Australia
  10. 10 School of Surgery, The University of Western Australia, Perth, Western Australia, Australia
  11. 11 Sydney Children's Hospital, School of Women’s and Children’s Health, UNSW, Sydney, New South Wales, Australia
  12. 12 Nelune Comprehensive Cancer Centre, Prince of Wales Children's Hospital, Randwick, New South Wales, Australia
  13. 13 Breast Cancer Network Australia, Camberwell, Victoria, Australia
  14. 14 School of Computing and Information Systems, The University of Melbourne, Melbourne, Victoria, Australia
  15. 15 Department of General Surgery, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
  16. 16 Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  17. 17 Breast Service, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  18. 18 Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
  19. 19 School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
  1. Correspondence to Dr Zobaida Edib; zedib{at}


Introduction As cancer treatments may impact on fertility, a high priority for young patients with breast cancer is access to evidence-based, personalised information for them and their healthcare providers to guide treatment and fertility-related decisions prior to cancer treatment. Current tools to predict fertility outcomes after breast cancer treatments are imprecise and do not offer individualised prediction. To address the gap, we are developing a novel personalised infertility risk prediction tool (FoRECAsT) for premenopausal patients with breast cancer that considers current reproductive status, planned chemotherapy and adjuvant endocrine therapy to determine likely post-treatment infertility. The aim of this study is to explore the feasibility of implementing this FoRECAsT tool into clinical practice by exploring the barriers and facilitators of its use among patients and healthcare providers.

Methods and analysis A cross-sectional exploratory study is being conducted using semistructured in-depth telephone interviews with 15–20 participants each from the following groups: (1) premenopausal patients with breast cancer younger than 40, diagnosed within last 5 years, (2) breast surgeons, (3) breast medical oncologists, (4) breast care nurses (5) fertility specialists and (6) fertility preservation nurses. Patients with breast cancer are being recruited from the joint Breast Service of three affiliated institutions of Victorian Comprehensive Cancer Centre in Melbourne, Australia—Peter MacCallum Cancer Centre, Royal Melbourne Hospital and Royal Women’s Hospital, and clinicians are being recruited from across Australia. Interviews are being audio recorded, transcribed verbatim and imported into qualitative data analysis software to facilitate data management and analyses.

Ethics and dissemination The study protocol has been approved by Melbourne Health Human Research Ethics Committee, Australia (HREC number: 2017.163). Confidentiality and privacy are maintained at every stage of the study. Findings will be disseminated through peer-reviewed scholarly and scientific journals, national and international conference presentations, social media, broadcast media, print media, internet and various community/stakeholder engagement activities.

  • breast cancer
  • premenopausal
  • infertility
  • risk prediction

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  • Collaborators FoRECAsT Consortium: Dr Michelle Peate, Dr Zobaida Edib, Prof Martha Hickey, Dr Yasmin Jayasinghe, Dr Shanton Chang, Dr Patrick Pang, Prof John Hopper, Dr Kevin Nguyen, Dr. Gillian Dite, Prof Uwe Aickelin, Xuetong Wu, Dr Hadi Akbarzadeh Khorshidi, Prof Ann Partridge, Dr Fabien Reyal, Ms Franca Agresta, Dr Genia Rozen, A/Prof Kate Stern, Dr Wanda Cui, Prof Kelly-Anne Phillips, Dr Laura Chin-Lenn, Dr Lesley Stafford, Dr Anne-Sophie Hamy, Dr Antoinette Anazodo, A/Prof H. Irene Su, Prof Richard Anderson, Prof Scott Nelson, Ms Alexandra Gorelik, Prof Liz Sullivan, Dr Alessandro Minisini, Prof Fabio Puglisi, Dr. Claudia Bozza, Prof Christobel Saunders, Dr Kathryn J. Ruddy, Dr Fergus J. Couch, Dr Janet E. Olson, Dr Isabelle Demeestere, Dr Margherita Condorelli, Dr Matteo Lambertini, Dr Michail Ignatiadis,Dr Barbara Pistilli, Ms Mary Macheras-Magias.

  • Contributors MP conceived the research idea, participated in the design of the study, development of all study documents, ethical approval process and reviewed this manuscript. ZE participated in the design of the study, development of all study documents, ethical approval process, study coordination and drafted this manuscript. YJ participated in the design of the study, development of all study documents and reviewed this manuscript. MH, LS, RAA, HIS, KS, CS, AA, MM-M, SC, PP and FA participated in the review of all study documents and the manuscript. LC-L and SP participated in ethics approval process and reviewed the manuscript. WC and AG reviewed the manuscript. All authors read and approved the final manuscript.

  • Funding This Research Project/Program was supported by the Victorian Government through a Victorian Cancer Agency (Early Career Seed Grant) awarded to Dr Peate.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study protocol has been reviewed and approved by the Human Research Ethics Committee of the Melbourne Health, Australia (HREC number: 2017.163).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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