The price of survival: Breast cancer patient preferences about fertility.
Bibliographic record
Abstract
9561 Background: Fertility is a concern for young women diagnosed with breast cancer. Concerns have been raised that women may avoid effective anti-cancer treatments to have an opportunity to preserve fertility. Here, we explore patient preferences for chemotherapy and whether women are willing to trade-off survival benefit to maintain fertility. Methods: During a standardized interview, outcomes associated with adjuvant chemotherapy and 5 years of tamoxifen (CT) or 5 years of tamoxifen alone (ET) were described to breast cancer survivors diagnosed within the past 2 years. A threshold task was performed in which each participant participated in two scenarios: (1) 10% absolute survival benefit from treatment and (2) 25% absolute survival benefit from treatment. Each participant was asked which treatment option they preferred when baseline fertility post treatment was reduced initially to 50% for both scenarios (i.e. 50% chance of conceiving naturally). If the participant indicated CT, post-treatment fertility was systematically reduced further until the participant’s preference changed from CT to ET. This threshold point represented the reduction in fertility the participant would accept before they would trade-off CT benefit. Descriptive statistics were used to characterize participants. Demographic factors (age, marital status, number of children at diagnosis and education) associated with willingness to trade-off survival benefit were evaluated with logistic regression. Results: Analysis comprised 50 women with a median age of 34.5 years (range 25-39 years). 39 (78%) women had completed university education. 34 (68%) and 45 (90%) women in scenario 1 and 2, respectively, were willing to trade-off all fertility (i.e. reduce fertility to 0% chance of conceiving naturally) in order to undertake CT and maintain survival benefits. 8 (16%) and 3 (6%) women in scenario 1 and 2, respectively, chose to not pursue CT at all in order to maintain fertility. Regression analysis did not identify any variables that were predictive of the participants’ preferences. Conclusions: Most young women with breast cancer are not willing to trade-off survival benefits of adjuvant therapy to maintain fertility.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".