乳がんに罹患した女性が薬物療法前に行う妊孕性温存の選択に対する意思決定支援：文献レビュー

Decision-making Support for Fertility Choices before Pharmacotherapy for Patients with Breast Cancer: A Literature Review

要旨

　【目的】国内外の文献をレビューし，乳がん女性が薬物療法前に行う妊孕性温存の選択に対する意思決定支援の実態と課題を明らかにする．

　【方法】MEDLINE，CINAHL，医学中央雑誌を用いて，2004年から2021年までの発表論文を対象に，キーワードは和文「乳房腫瘍」「妊孕性温存」，英文「Breast cancer」「Fertility preservation」とした．

　【結果】対象論文は8件で，意思決定に対する支援は「開発されたツールによる支援」と「医療専門職者によるコンサルテーション」に分類された．

　【結論】専門家の連携による支援効果は示されたが，意思決定支援ツールの効果は限定的で，情報提供の量や方法の更なる検討が示唆された．乳がん女性が行う妊孕性温存に関する選択は，様々な背景が関連しその影響は長期に及ぶため，医療者の連携と継続的支援を必要とする．わが国に応じた支援体制の構築が望まれる．

　The purpose of this study is to review domestic and international literature to identify the trends and issues in decision-making support for breast cancer patients regarding fertility choices.

　MEDLINE, CINAHL, and Japan Medical Abstracts Society Database (the ICHUSHI Web) were used to search for articles published between 2004 and 2021, with the keywords “breast tumor” and “fertility preservation” in both Japanese and English.

　Eight papers were included in the study, and decision making support were categorized as “support by developed tools” and “consultation by healthcare professionals”. The effectiveness of support through healthcare collaboration was demonstrated, but the outcomes of decision support tools was limited, suggesting further investigation on the amount and method of information provision. Fertility choices for women with breast cancer need healthcare collaboration and continuous support because of the variety of backgrounds and have a long-term impact. It is desirable to establish a support system that is appropriate for Japan.