Reproductive Choices and Family-building Decision Uncertainty Among Young Women at Familial Risk for Breast Cancer
Abstract
Background: A family history of breast cancer may impact reproductive choices and decisions about family-building. This study evaluated family-building considerations, plans, and decisional processes among women with a breast cancer family history, and examined sociodemographic, clinical, and psychosocial factors related to decision uncertainty. Methods: Cross-sectional data from the Breast Cancer Family Registry (BCFR) Young Women’s Study were analyzed. Participants were women (18-45 years old) with a breast cancer family history. They completed questionnaires including a Reproductive Choices module. Bivariate analyses and multiple regression evaluated relationships among study variables. Results: Participants (N=471) were on average 30.3 years old (SD=6.7), predominantly non-Hispanic White (75.1%), and over half were childless (58.6%); nearly half (47.8%) desired future children, 16.6% were unsure, and 35.7% did not. Among those interested/unsure (n=303), most considered natural conception (85.8%); many were unsure about alternative options such as embryo genetic testing, donor gametes, surrogacy, and adoption. Between 43–57% endorsed some degree of decision uncertainty. Perceived knowledge about genetic cancer risk and family-building options appeared low overall. In the final model, greater decision uncertainty was associated with having no history of pregnancy, identifying as Ashkenazi Jewish, endorsing concern about a future child's health, lack of concern about family-building timeline, and lower perceived knowledge about genetic cancer risk and family-building options. Conclusions: Among women with a familial risk for breast cancer, decision uncertainty about family-building options is prevalent and is driven by health-related concerns, knowledge gaps, financial barriers, and values-based considerations. Findings can inform targeted decision support interventions for this population.
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BibTeX
@misc{davis2026reproductive,
title = {{Reproductive Choices and Family-building Decision Uncertainty Among Young Women at Familial Risk for Breast Cancer}},
author = {Alexandra M. Davis and Jennifer Barsky Reese and Esther M. John and Allison W. Kurian and Jennifer S. Ford and Irene L. Andrulis and Sarah V. Colonna and Mary B. Daly and Jeanine Genkinger and Melissa C. Southey and Mary Beth Terry and Catherine Benedict},
howpublished = {Research Square},
year = {2026},
month = oct,
doi = {10.21203/rs.3.rs-10935505/v1},
url = {https://doi.org/10.21203/rs.3.rs-10935505/v1},
note = {CC BY 4.0},
}
RIS
TY - UNPB
TI - Reproductive Choices and Family-building Decision Uncertainty Among Young Women at Familial Risk for Breast Cancer
AU - Alexandra M. Davis
AU - Jennifer Barsky Reese
AU - Esther M. John
AU - Allison W. Kurian
AU - Jennifer S. Ford
AU - Irene L. Andrulis
AU - Sarah V. Colonna
AU - Mary B. Daly
AU - Jeanine Genkinger
AU - Melissa C. Southey
AU - Mary Beth Terry
AU - Catherine Benedict
PY - 2026
DA - 2026/10/30
PB - Research Square
DO - 10.21203/rs.3.rs-10935505/v1
UR - https://doi.org/10.21203/rs.3.rs-10935505/v1
AB - Background: A family history of breast cancer may impact reproductive choices and decisions about family-building. This study evaluated family-building considerations, plans, and decisional processes among women with a breast cancer family history, and examined sociodemographic, clinical, and psychosocial factors related to decision uncertainty. Methods: Cross-sectional data from the Breast Cancer Family Registry (BCFR) Young Women’s Study were analyzed. Participants were women (18-45 years old) with a breast cancer family history. They completed questionnaires including a Reproductive Choices module. Bivariate analyses and multiple regression evaluated relationships among study variables. Results: Participants (N=471) were on average 30.3 years old (SD=6.7), predominantly non-Hispanic White (75.1%), and over half were childless (58.6%); nearly half (47.8%) desired future children, 16.6% were unsure, and 35.7% did not. Among those interested/unsure (n=303), most considered natural conception (85.8%); many were unsure about alternative options such as embryo genetic testing, donor gametes, surrogacy, and adoption. Between 43–57% endorsed some degree of decision uncertainty. Perceived knowledge about genetic cancer risk and family-building options appeared low overall. In the final model, greater decision uncertainty was associated with having no history of pregnancy, identifying as Ashkenazi Jewish, endorsing concern about a future child's health, lack of concern about family-building timeline, and lower perceived knowledge about genetic cancer risk and family-building options. Conclusions: Among women with a familial risk for breast cancer, decision uncertainty about family-building options is prevalent and is driven by health-related concerns, knowledge gaps, financial barriers, and values-based considerations. Findings can inform targeted decision support interventions for this population.
SN - 2693-5015
ER -