{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T23:27:09Z","timestamp":1769556429424,"version":"3.49.0"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100004802","name":"California Breast Cancer Research Program","doi-asserted-by":"publisher","award":["20OB\u20100144"],"award-info":[{"award-number":["20OB\u20100144"]}],"id":[{"id":"10.13039\/100004802","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004802","name":"California Breast Cancer Research Program","doi-asserted-by":"publisher","award":["P30\u2010CA008748"],"award-info":[{"award-number":["P30\u2010CA008748"]}],"id":[{"id":"10.13039\/100004802","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Young patients with breast cancer frequently receive chemotherapy and\/or endocrine therapy that adversely affect ovarian function, leading to fertility, pregnancy, and other reproductive health concerns. Despite available evidence\u2010based management strategies, dissemination to survivors and healthcare providers remains limited, resulting in substantial unmet informational and care needs. Web\u2010based survivorship care plans may offer an effective approach to address these gaps.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To evaluate the effect of a web\u2010based Reproductive Health Survivorship Care Plan (SCP\u2010R) on reproductive concerns and reproductive healthcare access among nulliparous young breast cancer survivors (YBCS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p>\n                      This is a secondary analysis of a 24\u2010week randomized controlled trial on the effectiveness of a web\u2010based SCP\u2010R addressing unmet informational and clinical management needs for breast cancer survivors aged 18\u201350\u2009years. The current analysis is restricted to nulliparous participants ages 18\u201340. The primary outcomes are improvement in fertility and pregnancy health concerns, as measured by the Reproductive Concerns After Cancer (RCAC) scale. The secondary outcome is fertility specialist access measured by referral, consultation, or treatment by a fertility specialist. Among 182 study participants from the parent trial, 47 met the inclusion criteria for the current study (17 in the intervention and 30 in the attention control). Mean age at diagnosis was 30.7 (SD\u2009=\u20093.5) years, and mean age at study participation was 34.0 (SD\u2009=\u20093.8) years. Fertility potential and pregnancy concerns improved in 35.3% of participants randomized to the intervention arm compared to 10.0% in the control arm (RR\u2009=\u20093.5, 95% CI\u2009=\u20091.01\u201312.34,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.05). Intervention arm participants were significantly more likely to receive a fertility specialist referral, schedule a fertility consult, or undergo fertility treatment (37.5% in the intervention arm vs. 6.7% in the control arm; RR\u2009=\u20095.6, 95% CI\u2009=\u20091.28\u201324.73,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The web\u2010based SCP\u2010R intervention led to improvements in fertility potential and pregnancy concerns over time and resulted in more YBCS accessing fertility specialists, highlighting the importance of age\u2010 and parity\u2010specific survivorship care interventions to address reproductive health concerns.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cnr2.70433","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T21:40:16Z","timestamp":1767908416000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of a Reproductive Health Survivorship Care Plan on Fertility, Pregnancy Concerns, and Accessing Reproductive Healthcare Among Young Nulliparous Breast Cancer Survivors"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0158-5488","authenticated-orcid":false,"given":"Ksenya","family":"Shliakhtsitsava","sequence":"first","affiliation":[{"name":"Deparment of Pediatrics, Division of Pediatric Hematolgoy and Oncology University of Texas Southwestern Medical Center  Dallas Texas USA"},{"name":"Harold C. Simmons Comprehensive Cancer Center University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaylyn S.","family":"Stark","sequence":"additional","affiliation":[{"name":"Department of Critical Care Palomar Health  Escondido California USA"},{"name":"School of Nursing, California State University San Marcos  San Marcos California USA"},{"name":"Division of Pediatrics, Department of Neonatal Intensive Care Providence Regional Medical Center  Everett Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanushree","family":"Prasad","sequence":"additional","affiliation":[{"name":"Harold C. Simmons Comprehensive Cancer Center University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Boles","sequence":"additional","affiliation":[{"name":"Department of Medicine and Moores Cancer Center University of California  San Diego California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana","family":"Chingos","sequence":"additional","affiliation":[{"name":"Young Survival Coalition  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Ehren","sequence":"additional","affiliation":[{"name":"Department of Chemical and Biomolecular Engineering University of Notre Dame  Notre Dame Indiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3950-4260","authenticated-orcid":false,"given":"Jessica R.","family":"Gorman","sequence":"additional","affiliation":[{"name":"College of Health School of Nutrition and Public Health Health Promotion and Health Behavior Program Oregon State University  Corvallis Oregon USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6028-4111","authenticated-orcid":false,"given":"Sally A. D.","family":"Romero","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Science and Moores Cancer Center University of California  San Diego California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9229-0380","authenticated-orcid":false,"given":"Jun J.","family":"Mao","sequence":"additional","affiliation":[{"name":"Integrative Medicine Service, Memorial Sloan Kettering Cancer Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0334-0871","authenticated-orcid":false,"given":"Paul","family":"Nathan","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology The Hospital for Sick Children  Toronto Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2604-8603","authenticated-orcid":false,"given":"Saro H.","family":"Armenian","sequence":"additional","affiliation":[{"name":"Department of Pediatrics City of Hope Comprehensive Cancer Center  Palo Alto California USA"},{"name":"Department of Population Sciences City of Hope Comprehensive Cancer Center  Palo Alto California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6671-5151","authenticated-orcid":false,"given":"H. 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