Bibliometric and visual analysis of fertility-related decision-making conflict and support needs among breast cancer patients_West China Medical Journal

Authors：

ZHANG Haichao ^1,2 , CHEN Juan ² , ZHU Yulan ³ , JIANG Tingting ⁴ ,  ZHANG Xiaoxia ⁵

1. West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
4. Department of Biotherapy Research, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
5. Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

ZHANG Xiaoxia, Email: zhangxiaoxia@scu.edu.cn

Keywords：

Breast cancer; social support; fertility; bibliometrics

DOI：

10.7507/1002-0179.202604199

Video：

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Objective To systematically sort out the research status, hotspots and development trends in the field of fertility-related decision-making conflict and support needs among breast cancer patients using bibliometric methods, so as to provide references for subsequent research and clinical practice. Methods Based on the Web of Science Core Collection, relevant studies on fertility-related decision-making conflict and support needs among breast cancer patients published from 1995 to 2025 were retrieved. Excel 2021, CiteSpace 6.3.R1 and VOSviewer 1.6.19 were used to analyze the elements including countries, institutions, authors, journals and keywords. Results A total of 1113 publications were included. Early-stage publication output increased slowly, its growth rate rose significantly after 2007, and reached a peak of 116 publications in 2025. The United States accounted for 43.8% of total publications, and Harvard University and its affiliated institutions were the core contributing forces. Core journals showed interdisciplinary characteristics, while highly-cited literature was highly concentrated in the field of oncology. Keyword analysis revealed that research themes fell into three categories: clinical epidemiology and genetic risk research, therapeutic intervention and fertility preservation research, quality of life and support needs research. Quality of life and support needs may be future research hotspots. Conclusions The field of fertility-related decision-making and support for women with breast cancer has evolved into a multidisciplinary research frontier, with its research focus shifting from biomedical and technical discussions toward patient-centered decision-making support and humanistic care. Further in-depth research could be carried out targeting hot topics in the future to promote the development of this field toward precision and intelligence.

Citation： ZHANG Haichao, CHEN Juan, ZHU Yulan, JIANG Tingting, ZHANG Xiaoxia. Bibliometric and visual analysis of fertility-related decision-making conflict and support needs among breast cancer patients. West China Medical Journal, 2026, 41(8): 1289-1294. doi: 10.7507/1002-0179.202604199 Copy

1.	Arecco L, Borea R, Magaton IM, et al. Current practices in oncofertility counseling: updated evidence on fertility preservation and post-treatment pregnancies in young women affected by early breast cancer[J]. Expert Rev Anticanc, 2024, 24(9): 803-817.
2.	Sachdev PA, Ayad NG, Constantinou C. Breast cancer treatment and fertility preservation: a narrative review of impacts, strategies and ethical considerations[J]. Curr Oncol Rep, 2024, 26(12): 1575-1585.
3.	Sun M, Liu C, Zhang P, et al. Perspectives and needs for fertility preservation decision-making in childbearing-age patients with breast cancer: a qualitative study[J]. Asia Pac J Oncol Nurs, 2024, 11(8): 100548.
4.	Lambertini M, Blondeaux E, Bruzzone M, et al. Pregnancy after breast cancer: a systematic review and meta-analysis[J]. J Clin Oncol, 2021, 39(29): 3293-3305.
5.	王彬, 李燕姿. 年輕乳腺癌患者生育力保存的治療與倫理思考[J]. 中國醫學倫理學, 2021, 34(1): 88-92.
6.	Yoshida K, Hashimoto T, Koizumi T, et al. Psychosocial experiences regarding potential fertility loss and pregnancy failure after treatment in cancer survivors of reproductive age to identify psychosocial care needs: a systematic review[J]. Support Care Cancer, 2024, 32(6): 337.
7.	Carr AL, Roberts S, Bonnell LN, et al. Existential distress and meaning making among female breast cancer patients with cancer-related fertility concerns[J]. Palliat Support Care, 2023, 21(2): 196-204.
8.	Donthu N, Kumar S, Mukherjee D, et al. How to conduct a bibliometric analysis: an overview and guidelines[J]. J Bus Res, 2021, 133: 285-296.
9.	Lambertini M, Goldrat O, Clatot F, et al. Controversies about fertility and pregnancy issues in young breast cancer patients: current state of the art[J]. Curr Opin Oncol, 2017, 29(4): 243-252.
10.	de Kermadec E, Zheng Y, Rosenberg S, et al. Fertility concerns and treatment decision-making among national sample of young women with breast cancer[J]. Cancer Med, 2024, 13(1): e6838.
11.	Waks AG, Partridge AH. Fertility preservation in patients with breast cancer: necessity, methods, and safety[J]. J Natl Compr Canc Netw, 2016, 14(3): 355-363.
12.	Ruggeri M, Pagan E, Bagnardi V, et al. Fertility concerns, preservation strategies and quality of life in young women with breast cancer: baseline results from an ongoing prospective cohort study in selected European centers[J]. Breast, 2019, 47: 85-92.
13.	Song L, Edib Z, Aickelin U, et al. Development of a machine learning model for predicting treatment-related amenorrhea in young women with breast cancer[J]. Bioengineering (Basel), 2025, 12(11): 1171.
14.	曹龍女, 崔洪全, 曹斐. 育齡期乳腺癌患者生育研究現狀與前沿分析[J]. 中國優生與遺傳雜志, 2024, 32(8): 1618-1625.
15.	Roof KA, Andre KE, Modesitt SC, et al. Maximizing ovarian function and fertility following chemotherapy in premenopausal patients: is there a role for ovarian suppression?[J]. Gynecol Oncol Rep, 2024, 53: 101383.
16.	Chiu HC, Lin CY, Shu BC, et al. Planned motherhood distress in women of reproductive age with breast cancer-impacts of partner relationship, fear of cancer recurrence, decision conflict, and fertility concerns[J]. Eur J Oncol Nurs, 2025, 76: 102859.
17.	Su HI, Lacchetti C, Letourneau J, et al. Fertility preservation in people with cancer: ASCO guideline update[J]. J Clin Oncol, 2025, 43(12): 1488-1515.
18.	Dessolle L, Ferrier D, Colombel A, et al. Prolonging GnRH-agonist to achieve ovarian suppression does not compromise the results of a long protocol[J]. Eur J Obstet Gynecol Reprod Biol, 2011, 159(1): 111-114.
19.	Peate M, Meiser B, Friedlander M, et al. It’s now or never: fertility-related knowledge, decision-making preferences, and treatment intentions in young women with breast cancer--an Australian fertility decision aid collaborative group study[J]. J Clin Oncol, 2011, 29(13): 1671-1677.
20.	Canola MM, Kaklamani VG. Anti-estrogen therapy and fertility preservation in premenopausal breast cancer patients: a review[J]. Curr Breast Cancer Rep, 2022, 14(2): 29-36.
21.	Tseng LM, Lien PJ, Huang CY, et al. Developing a web-based shared decision-making tool for fertility preservation among reproductive-age women with breast cancer: an action research approach[J]. J Med Internet Res, 2021, 23(3): e24926.
22.	Lee SJ, Schover LR, Partridge AH, et al. American Society of Clinical Oncology recommendations on fertility preservation in cancer patients[J]. J Clin Oncol, 2006, 24(18): 2917-2931.
23.	Li M, Li X, Shang J. Global trends in patient-reported outcomes and quality-of-life research for breast cancer: a 20-year bibliometric study[J]. Cancer Causes Control, 2026, 37(2): 20.
24.	Hawkey AJ, Ussher JM, Perz J, et al. The impact of cancer-related fertility concerns on current and future couple relationships: people with cancer and partner perspectives[J]. Eur J Cancer Care (Engl), 2021, 30(1): e13348.
25.	Liu W, Lewis FM, Oxford M, et al. Common dyadic coping and its congruence in couples facing breast cancer: the impact on couples’ psychological distress[J]. Psychooncology, 2024, 33(3): e6314.
26.	Corney R, Puthussery S, Swinglehurst J. The stressors and vulnerabilities of young single childless women with breast cancer: a qualitative study[J]. Eur J Oncol Nurs, 2014, 18(1): 17-22.
27.	Barjasteh S, Farnam F, Elsous A, et al. Overcoming reproductive and psychological concerns of breast cancer survivors: a randomized controlled trial[J]. J Family Reprod Health, 2022, 16(1): 52-60.
28.	Gorman JR, Drizin JH, Smith E, et al. Patient-centered communication to address young adult breast cancer survivors’ reproductive and sexual health concerns[J]. Health Commun, 2021, 36(13): 1743-1758.
29.	Teixeira MS, Bártolo A, Monteiro S. Exploring fertility information needs and preferences in young women diagnosed with breast cancer: a qualitative study[J]. Eur Psychiat, 2023, 66(1): 361-360.

1. Arecco L, Borea R, Magaton IM, et al. Current practices in oncofertility counseling: updated evidence on fertility preservation and post-treatment pregnancies in young women affected by early breast cancer[J]. Expert Rev Anticanc, 2024, 24(9): 803-817.
2. Sachdev PA, Ayad NG, Constantinou C. Breast cancer treatment and fertility preservation: a narrative review of impacts, strategies and ethical considerations[J]. Curr Oncol Rep, 2024, 26(12): 1575-1585.
3. Sun M, Liu C, Zhang P, et al. Perspectives and needs for fertility preservation decision-making in childbearing-age patients with breast cancer: a qualitative study[J]. Asia Pac J Oncol Nurs, 2024, 11(8): 100548.
4. Lambertini M, Blondeaux E, Bruzzone M, et al. Pregnancy after breast cancer: a systematic review and meta-analysis[J]. J Clin Oncol, 2021, 39(29): 3293-3305.
5. 王彬, 李燕姿. 年輕乳腺癌患者生育力保存的治療與倫理思考[J]. 中國醫學倫理學, 2021, 34(1): 88-92.
6. Yoshida K, Hashimoto T, Koizumi T, et al. Psychosocial experiences regarding potential fertility loss and pregnancy failure after treatment in cancer survivors of reproductive age to identify psychosocial care needs: a systematic review[J]. Support Care Cancer, 2024, 32(6): 337.
7. Carr AL, Roberts S, Bonnell LN, et al. Existential distress and meaning making among female breast cancer patients with cancer-related fertility concerns[J]. Palliat Support Care, 2023, 21(2): 196-204.
8. Donthu N, Kumar S, Mukherjee D, et al. How to conduct a bibliometric analysis: an overview and guidelines[J]. J Bus Res, 2021, 133: 285-296.
9. Lambertini M, Goldrat O, Clatot F, et al. Controversies about fertility and pregnancy issues in young breast cancer patients: current state of the art[J]. Curr Opin Oncol, 2017, 29(4): 243-252.
10. de Kermadec E, Zheng Y, Rosenberg S, et al. Fertility concerns and treatment decision-making among national sample of young women with breast cancer[J]. Cancer Med, 2024, 13(1): e6838.
11. Waks AG, Partridge AH. Fertility preservation in patients with breast cancer: necessity, methods, and safety[J]. J Natl Compr Canc Netw, 2016, 14(3): 355-363.
12. Ruggeri M, Pagan E, Bagnardi V, et al. Fertility concerns, preservation strategies and quality of life in young women with breast cancer: baseline results from an ongoing prospective cohort study in selected European centers[J]. Breast, 2019, 47: 85-92.
13. Song L, Edib Z, Aickelin U, et al. Development of a machine learning model for predicting treatment-related amenorrhea in young women with breast cancer[J]. Bioengineering (Basel), 2025, 12(11): 1171.
14. 曹龍女, 崔洪全, 曹斐. 育齡期乳腺癌患者生育研究現狀與前沿分析[J]. 中國優生與遺傳雜志, 2024, 32(8): 1618-1625.
15. Roof KA, Andre KE, Modesitt SC, et al. Maximizing ovarian function and fertility following chemotherapy in premenopausal patients: is there a role for ovarian suppression?[J]. Gynecol Oncol Rep, 2024, 53: 101383.
16. Chiu HC, Lin CY, Shu BC, et al. Planned motherhood distress in women of reproductive age with breast cancer-impacts of partner relationship, fear of cancer recurrence, decision conflict, and fertility concerns[J]. Eur J Oncol Nurs, 2025, 76: 102859.
17. Su HI, Lacchetti C, Letourneau J, et al. Fertility preservation in people with cancer: ASCO guideline update[J]. J Clin Oncol, 2025, 43(12): 1488-1515.
18. Dessolle L, Ferrier D, Colombel A, et al. Prolonging GnRH-agonist to achieve ovarian suppression does not compromise the results of a long protocol[J]. Eur J Obstet Gynecol Reprod Biol, 2011, 159(1): 111-114.
19. Peate M, Meiser B, Friedlander M, et al. It’s now or never: fertility-related knowledge, decision-making preferences, and treatment intentions in young women with breast cancer--an Australian fertility decision aid collaborative group study[J]. J Clin Oncol, 2011, 29(13): 1671-1677.
20. Canola MM, Kaklamani VG. Anti-estrogen therapy and fertility preservation in premenopausal breast cancer patients: a review[J]. Curr Breast Cancer Rep, 2022, 14(2): 29-36.
21. Tseng LM, Lien PJ, Huang CY, et al. Developing a web-based shared decision-making tool for fertility preservation among reproductive-age women with breast cancer: an action research approach[J]. J Med Internet Res, 2021, 23(3): e24926.
22. Lee SJ, Schover LR, Partridge AH, et al. American Society of Clinical Oncology recommendations on fertility preservation in cancer patients[J]. J Clin Oncol, 2006, 24(18): 2917-2931.
23. Li M, Li X, Shang J. Global trends in patient-reported outcomes and quality-of-life research for breast cancer: a 20-year bibliometric study[J]. Cancer Causes Control, 2026, 37(2): 20.
24. Hawkey AJ, Ussher JM, Perz J, et al. The impact of cancer-related fertility concerns on current and future couple relationships: people with cancer and partner perspectives[J]. Eur J Cancer Care (Engl), 2021, 30(1): e13348.
25. Liu W, Lewis FM, Oxford M, et al. Common dyadic coping and its congruence in couples facing breast cancer: the impact on couples’ psychological distress[J]. Psychooncology, 2024, 33(3): e6314.
26. Corney R, Puthussery S, Swinglehurst J. The stressors and vulnerabilities of young single childless women with breast cancer: a qualitative study[J]. Eur J Oncol Nurs, 2014, 18(1): 17-22.
27. Barjasteh S, Farnam F, Elsous A, et al. Overcoming reproductive and psychological concerns of breast cancer survivors: a randomized controlled trial[J]. J Family Reprod Health, 2022, 16(1): 52-60.
28. Gorman JR, Drizin JH, Smith E, et al. Patient-centered communication to address young adult breast cancer survivors’ reproductive and sexual health concerns[J]. Health Commun, 2021, 36(13): 1743-1758.
29. Teixeira MS, Bártolo A, Monteiro S. Exploring fertility information needs and preferences in young women diagnosed with breast cancer: a qualitative study[J]. Eur Psychiat, 2023, 66(1): 361-360.

West China Medical Journal

Bibliometric and visual analysis of fertility-related decision-making conflict and support needs among breast cancer patients

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