Use of Epic SlicerDicer to assess pregnancy rates in adolescent and young adult patients with breast cancer.

Abstract

e23353 Background: Adolescent and young adult (AYA) cancer patients represent an underserved population with unique psychosocial and supportive care needs. Breast cancer diagnoses are increasing in this age group, presenting challenges for family planning and sexual wellness. AYA cancer survivors often experience unmet needs and insufficient information concerning sexuality and fertility. Methods: We conducted a retrospective single-institution cohort study using deidentified data from the electronic medical record (EPIC) and the SlicerDicer tool at the University of Rochester Medical Center. Patients with a chief complaint of breast cancer between January 1, 2020, and January 1, 2025, were included. We collected descriptive statistics on age, national percentile area deprivation index, top 10 grouped ICD diagnoses, post-diagnosis pregnancy rate, use of leuprolide or goserelin, oncologic therapies, and surgeries. Results: A total of 233 patients were identified. Age distribution was 7.7% between 20-30 years, 56.2% between 30-40 years, and 36.1% between 40-45 years. The cohort was predominantly white (76.8%), with 11.2% black, 3.4% Asian, and 12% other races. Only 3 patients were male. 75% of the population were in the 50th percentile or above in area deprivation index by zip code, disproportionately distributed across race. Leuprolide or goserelin was administered to 43.8% of patients, not directly correlating with hormone therapy receipt. Systemic therapy was received by 68.2% of patients, with 48.5% receiving hormone therapy. Surgical interventions included partial or full mastectomy (41.6%), salpingo-oophorectomy (3.9%), and hysterectomy (3%). Post-diagnosis pregnancy rate was 16.7%, with numbers too small for subgroup analysis based on race, area deprivation index, or therapy type. Conclusions: Electronic medical record data can be used to obtain real-time practice and sexual health patterns in oncology populations. Pregnancies were observed across nearly all therapy groups, highlighting the importance of fertility counseling and family planning discussions for AYA breast cancer patients. This study demonstrates the utility of tools like Epic Slicer Dicer in assessing reproductive outcomes in this unique patient population.