Retrospective audit of contraception and sexual health in newly diagnosed breast cancer patients

Introduction: For women with breast cancer, contraception is a challenge in the management of their sexual and reproductive health, and sexual health problems are overlooked despite being commonly experienced side effects of anti-cancer therapies. The objective was to describe trends in contraceptive counselling and sexual health problem management at a tertiary metropolitan comprehensive cancer centre. Materials and methods: A descriptive retrospective audit of the Electronic Medical Records (EMR) of women aged 18–50 with early-stage breast cancer was conducted. Data were entered into REDCap, and descriptive statistics and confidence intervals for proportions were calculated. Fisher’s Exact Testing was used. Results: Ninety-four records were analysed. Under half (49% [46/94], 95% CI: 38–59%) had a contraceptive method documented (including no contraception; n = 18), and 11% (10/94, 95% CI: 5–19%) had contraceptive counselling. Whilst patients taking tamoxifen had a greater frequency of counselling than patients on other oral therapies, the likelihood was not significant (p = 0.108). Eighteen patients were on hormonal contraception during their initial consultation; however, only nine patients had clinicians document a change. The majority (76%, 95% CI: 66–84%; n = 71) had a sexual and reproductive history taken, and twenty-three reported sexual health issues. The most common side effects of anti-cancer therapies were body image, emotional symptoms, and libido. Conclusions: Contraceptive counselling and sexual health are poorly documented in breast cancer patients’ overall treatment, suggesting they are either under-prioritised and/or challenging to record. Contraceptive prescribing for women with hormonally mediated cancers is also not in accordance with clinical guidelines, increasing women’s pregnancy risk.