Background: Despite ASCO recommendations (2006, 2013), young cancer patients are frequently not spoken to about the potential effects of treatment on future fertility and are denied the option of FP. Last year we began a 5 year study (SPOKE: Surgeon and Patient Oncofertility Knowledge Enhancement) to increase FP discussion and referral rates of Canadian breast surgeons. To design effective interventions, in addition to interviewing and surveying surgeons we conducted in-depth interviews with young BCS. Methods: Thirty minute semi-structured telephone interviews were conducted with BCS diagnosed < age 40 to explore their oncofertility experiences and their recommendations for future patients. Eligible BCS were recruited by oncologists and fertility specialists. A patient sample was deliberately chosen to reflect diversity of tumor stage, patient demographics and fertility experiences. A $20 incentive was given to each interviewee. Interviews were audio-recorded, transcribed verbatim and the data analyzed using qualitative methods. Subject recruitment was terminated when saturation of themes was obtained. Results: Fifteen BCS from 5 provinces, mean age 32 were interviewed. At diagnosis mean age was 29 with 8 (53%) single, 13 (87%) nulliparous, and 87% receiving adjuvant chemotherapy. At diagnosis all but 1 BCS had either definitely (60%) or possibly (33%) wanted (additional) children but only 8 of the 14 (57%) had been referred for a FP consult. Common recommendations were: discussing fertility as soon as possible after diagnosis to optimize time for decision-making; providing up-to-date information about the various FP options prior to the consult; and encouraging patients ambivalent about future childbearing to pursue FP. Conclusions: Despite the perception by many surgeons that patients are not psychologically able to handle information about fertility and FP at the time of their diagnosis, the majority of BCS interviewed thought that early fertility discussion by the surgical team was essential. SPOKE will include knowledge translations interventions for surgeons, and the creation of a FP information ‘toolbox’ with separate versions for surgeons and patients. Funded by the CBCF and CIHR.