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Reproductive Health and Cancer in Adolescents and Young Adults pp 77–87Cite as

The Unique Reproductive Concerns of Young Women with Breast Cancer

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Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 732))

Abstract

Many young women with breast cancer are interested in having a biologic child in the future. However, adjuvant chemotherapy can cause ovarian toxicity and fertility naturally declines due to ovarian aging that occurs during the recommended five years of treatment with adjuvant hormonal therapy. Decisions about fertility after breast cancer are further complicated by concerns about the safety of fertility preservation and subsequent pregnancy after breast cancer, despite limited available data for safety. At the present time, the most reliable fertility preservation method for breast cancer patients is embryo cryopreservation prior to treatment, although alternative options exist. In an effort to allow women to pursue fertility preservation if warranted and avoid excessive treatment delay, it is important to consider fertility concerns early in the care of young women with breast cancer.

I am a 35 year old woman whose boyfriend found a mass in my breast two months ago. A biopsy showed it was breast cancer, and I was ultimately recommended to undergo chemotherapy and tamoxifen in addition to surgery. I told them I would very much like to be able to have children in the future, so my oncologist said I should consider embryo cryopreservation, as my likelihood of being able to conceive naturally after chemotherapy and at age 40, when the tamoxifen was finished, would not be high. However, she acknowledged that no one is sure whether ovarian stimulation prior to treatment, especially when my cancer was hormone sensitive, is safe. I met with a reproductive endocrinologist later that week, and we went over the pros and cons of fertility preservation options. My boyfriend I discussed it and we decided to move forward with embryo cryopreservation. Because my period had recently finished, I started ovarian stimulation quickly and had eggs harvested, fertilized with my boyfriend’s sperm, and frozen less than two weeks later. I started chemotherapy the next day. While I realize there is uncertainty about the safety of pregnancy after breast cancer, knowing that I have taken steps to preserve my fertility is very reassuring to me as I begin my treatment.

Diana, Breast Cancer Survivor

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Authors and Affiliations

  1. Dana-Farber Cancer Institute, Boston, MA, 02215, USA

    Kathryn J. Ruddy MD, MPH & Ann H. Partridge MD, MPH

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  1. Kathryn J. Ruddy MD, MPH
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  2. Ann H. Partridge MD, MPH
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Correspondence to Kathryn J. Ruddy MD, MPH .

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Editors and Affiliations

  1. Moffitt Cancer Center, Magnolia Drive 12902, Tampa, 33612, Florida, USA

    Gwendolyn P. Quinn

  2. Moffitt Cancer Center, Magnolia Drive 12902, Tampa, 33612, Florida, USA

    Susan T. Vadaparampil

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Ruddy, K.J., Partridge, A.H. (2012). The Unique Reproductive Concerns of Young Women with Breast Cancer. In: Quinn, G., Vadaparampil, S. (eds) Reproductive Health and Cancer in Adolescents and Young Adults. Advances in Experimental Medicine and Biology, vol 732. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-2492-1_6

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