Breaking the Silence: Barriers to Fertility Preservation Among Young Breast Cancer Patients in Ghana - a multicenter study.

Background: Breast cancer is the most common cancer among women in Ghana and a leading cause of cancer-related mortality. While incidence increases with age, many cases occur in women of childbearing age, often a decade earlier than in Caucasian populations. Although advances in treatment have improved survival, chemotherapy and radiation therapy carry a risk of infertility. Despite global recommendations for early fertility preservation (FP) counselling, limited data exist from Ghana. Methods: A cross-sectional, multicentre study using a quantitative survey was conducted at Korle Bu Teaching Hospital and the National Radiotherapy Oncology Centre. Eligible participants were reproductive-aged women with breast cancer. Exclusions included women who had completed childbearing or were not intending to have biological children. Data on sociodemographic, cancer treatment, FP awareness, and barriers were collected using structured questionnaires and analysed in SPSS v22. Results: Among 300 participants (mean age 44.5 years), FP awareness was 39.3%. Major barriers included cost (73.5%, p < 0.001), fear (50%), and partner objection (14.3%). Younger age, low parity, and single status were significantly associated with FP preference. Conclusion: Cost, limited awareness, and sociocultural factors impede FP uptake. Integrating fertility counselling into cancer care could improve outcomes for young breast cancer patients.