Fertility Counseling and Preservation in Breast Cancer
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Purpose of Review
Young women represent a minority of breast cancer patients for which fertility, family planning, and pregnancy represent unique vulnerabilities. This review intends to discuss recent published evidence regarding treatment-related infertility, fertility counseling, and preservation.
Fertility concerns are common among young women with breast cancer and may negatively affect treatment decisions. Data is available to aid providers in approximating odds of post-treatment amenorrhea and infertility. Multiple fertility preservation techniques are available. While embryo preservation is most commonly used, recent guidelines endorse oocyte preservation and support for ovarian tissue cryopreservation is increasing. Most recently, the contribution of ovarian suppression during chemotherapy to ovarian function preservation has been established. Germline BRCA mutations may impact fertility potential and challenge fertility preservation and preimplantation genetic testing should be discussed with this subset.
Fertility counseling and preservation have become an integral part of the multidisciplinary care for breast cancer at diagnosis and throughout survivorship. Efforts to further individualize recommendations are necessary.
KeywordsFertility Gonadotoxicity Pregnancy Cryopreservation Prenatal genetic testing Breast cancer
Dr. Sella is a Goldfarb Advanced Fellow in Breast Oncology at DFCI and is also supported by The American Physicians Fellowship for Medicine in Israel and the Pinchas Burstein Talpiot Medical Leadership Program, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
Compliance with Ethical Standards
Conflict of Interest
Tal Sella reports personal fees from Roche outside the submitted work. Ann H. Partridge declares no conflicts of interest relevant to this manuscript.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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