Addressing Fertility: an Essential Aspect of Comprehensive Care for Young Patients with Breast Cancer

Ami N. Shah*, Marissa Luck, Kara Goldman, William Gradishar

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Purpose of Review: Approximately 12,000 women between 20 and 39 years of age are diagnosed with invasive breast cancer (BC) annually in the USA. We aim to summarize data regarding the impact of BC treatment on fertility and strategies for fertility preservation in young women with BC. Recent Findings: Standard curative therapies for breast cancer can lead to subfertility, infertility, and primary ovarian insufficiency by their direct gonadotoxic effects and/or by delaying the age at which a woman can attempt pregnancy. Oocyte and embryo cryopreservation are the preferred options for fertility preservation and, if done efficiently within an established referral system, will not negatively impact long-term outcomes or the ability to receive neoadjuvant therapy in a timely fashion. Gonadotropin-releasing hormone agonists may be included alongside chemotherapy but should not be relied on for fertility preservation. Summary: All premenopausal women should be counseled regarding the potential impact of systemic therapies on fertility. A multi-disciplinary approach is needed, including early referral to reproductive endocrinology, to effectively address fertility concerns in young patients with breast cancer.

Original languageEnglish (US)
Pages (from-to)381-390
Number of pages10
JournalCurrent Breast Cancer Reports
Volume12
Issue number4
DOIs
StatePublished - Dec 2020

Keywords

  • Breast cancer
  • Chemotherapy
  • Fertility preservation
  • Gonadotoxic therapy
  • Premenopausal breast cancer

ASJC Scopus subject areas

  • Oncology

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