旨在评估患有早期乳腺癌的年轻女性的避孕使用情况和变化。对整群随机试验进行二次分析。多机构。从 54 个美国肿瘤诊所招募年龄≤45 岁的新诊断乳腺癌患者。研究地点随机分配给年轻女性妇女干预，针对新诊断出乳腺癌的年轻女性及其肿瘤科医生的教育干预，解决该人群特有的问题，包括避孕或接触时间控制身体活动干预。参与者完成了后续调查，包括为期 3 个月的关于诊断前后避孕措施的调查。感兴趣的结果包括年轻女性在乳腺癌诊断前和研究入组后 3 个月的避孕措施使用和方法。 Logistic 回归模型评估了与使用不太有效的避孕方法相关的因素，这些因素根据世界卫生组织的有效性等级和避孕方法的变化进行分类。在 312 名女性中，258 名 (83%) 报告在乳腺癌诊断前使用了避孕措施，275 名 (83%) 报告在乳腺癌诊断前使用了避孕措施。 88%）报告诊断后采取了避孕措施。使用高效方法（例如输精管结扎术、非激素宫内节育器）的比例从诊断前的 39% 增加到诊断后的 52%。使用中等有效方法（例如激素方法）的比例从诊断前的 22% 下降到诊断后的 3%。使用效果较差的方法（例如安全套、戒断）的比例从诊断前的 22% 增加到诊断后的 34%。在多变量分析中，与诊断后使用效果不佳的避孕措施相关的因素包括想要更多孩子的愿望（比值比 [OR]，6.33；95% 置信区间 [CI]，3.76-10.66）以及与提供者讨论避孕措施（OR， 1.96；95% CI，1.12-3.40）。乳腺癌诊断后，207 名患者 (66%) 报告避孕方法没有改变。多变量分析显示，诊断后与避孕方法改变相关的因素包括年龄<35岁（OR，2.96；95% CI，1.57-5.58）和提供者讨论（OR，3.59；95% CI，1.91-6.78）。两项分析与研究组均没有关联。尽管大多数患者在乳腺癌诊断后采取了避孕措施，但近一半的患者报告使用的避孕方法不太有效，失败率较高，这突显了年轻乳腺癌患者需要早期和改进的避孕咨询cancer.NCT01647607.版权所有 © 2024 美国生殖医学会。由爱思唯尔公司出版。保留所有权利。

To evaluate contraception use and change among young women with early breast cancer.Secondary analysis of a cluster randomized trial.Multi-institutional.Patients with newly diagnosed breast cancer age ≤45 years enrolled from 54 US oncology practices.Sites were randomly assigned to the Young Women's Intervention, an educational intervention for young women with newly diagnosed breast cancer and their oncologists addressing issues specific to this population, including contraception, or a contact-time control physical activity intervention. Participants completed surveys in follow-up, including a 3-month survey regarding contraceptive practices before and after diagnosis.Outcomes of interest included young women's contraceptive use and methods before breast cancer diagnosis and 3 months after study enrollment. Logistic regression models assessed factors associated with use of less than highly effective contraceptive methods categorized according to World Health Organization effectiveness tiers and changes in contraceptive methods.Of 312 women included, 258 (83%) reported contraceptive use before breast cancer diagnosis, and 275 (88%) reported contraceptive use after diagnosis. Use of highly effective methods (e.g., vasectomy, non-hormonal intrauterine devices) increased from 39% before diagnosis to 52% after diagnosis. Use of moderately effective methods (e.g., hormonal methods) decreased from 22% before diagnosis to 3% after diagnosis. Use of less effective methods (e.g., condoms, withdrawal) increased from 22% before diagnosis to 34% after diagnosis. On multivariable analysis, factors associated with using less than highly effective contraception after diagnosis included desire for additional children (odds ratio [OR], 6.33; 95% confidence interval [CI], 3.76-10.66) and discussing contraception with a provider (OR, 1.96; 95% CI, 1.12-3.40). After breast cancer diagnosis, 207 patients (66%) reported no change in contraceptive methods. On multivariable analysis, factors associated with contraceptive method change after diagnosis included age <35 years (OR, 2.96; 95% CI, 1.57-5.58) and provider discussion (OR, 3.59; 95% CI, 1.91-6.78). There was no association in either analysis with study arm.Although most patients used contraception after breast cancer diagnosis, nearly half reported using less than highly effective contraceptive methods with higher failure rates, highlighting the need for early and improved contraceptive counseling for young women with breast cancer.NCT01647607.Copyright © 2024 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.