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Young women with breast cancer: how many are actually candidates for fertility preservation?

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

There are no data regarding the actual need for fertility preservation (FP) in breast cancer (BC) patients. Our study provides a practical needs assessment for reproductive medicine by analyzing an unselected cohort of young BC patients. This assessment considers oncological factors as well as the patient’s obstetrical and gynecological history and reproductive outcome after BC diagnosis. We aimed to identify how many patients are actually potential candidates for FP and how many patients might consequently use their cryopreserved gametes to achieve pregnancy.

Methods

Based on a prospective BC database, we analyzed all patients who were ≤40 years at initial diagnosis (time period of diagnosis: 1990–2007; n = 100; 7.7 % of the entire BC cohort; median age: 35.9 years).

Results

Using an algorithm of exclusion criteria considering disease-specific, therapy-specific and family history characteristics, 36 patients who received chemotherapy were identified as potential “classical” candidates for FP. After 5 years, 22 women were identified as potential candidates for using their cryopreserved gametes to achieve pregnancy; the majority of these patients were childless (n = 16, 72.7 %) and in their late reproductive years (n = 12, 54.5 %).

Conclusions

Our study demonstrates that in a cohort of young BC patients only a minority of women are candidates for FP. Young BC patients who wish to have children in the future usually carry risk factors both from oncological and reproductive medicine perspective. Due to this high-risk profile, the rarity of BC in young age and the limited number of patients who might actually have opted for FP, these women must be offered timely and multidisciplinary counseling in highly specialized centers.

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Conflict of interest

The authors declare that there are no financial or personal relationships with other people or organizations that could inappropriately influence the work reported or the conclusions, implications, or opinions stated.

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Authors and Affiliations

  1. Clinic for Gynecologic Endocrinology and Reproductive Medicine, Women’s Hospital, University Hospital Basel (UHB), Spitalstrasse 21, 4031, Basel, Switzerland

    Rebecca Moffat & Christian de Geyter

  2. UHB, Breast Center, Spitalstrasse 21, 4031, Basel, Switzerland

    Rebecca Moffat, Christian de Geyter, Christina Sattmann, Sibil Tschudin, Nerbil Kilic & Uwe Güth

  3. Department of Pediatric Surgery, Inselspital Bern, University Hospital, 3010, Bern, Switzerland

    Mary E. Myrick

  4. Spital Grabs, Frauenklinik, Spitalstrasse 44, 9472, Grabs, Switzerland

    Seraina M. Schmid

  5. Division for Gynecology and Gyn. Oncology, Women’s Hospital, UHB, Spitalstrasse 21, 4031, Basel, Switzerland

    Christina Sattmann, Sibil Tschudin & Uwe Güth

  6. Department of Medical Oncology, UHB, Petersgraben 4, 4031, Basel, Switzerland

    Nerbil Kilic

  7. Department of Gynecology and Obstetrics, Breast Center, Cantonal Hospital Winterthur, Brauerstrasse 15, 8401, Basel, Switzerland

    Uwe Güth

Authors
  1. Rebecca Moffat
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  2. Christian de Geyter
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  3. Mary E. Myrick
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  5. Christina Sattmann
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  6. Sibil Tschudin
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  7. Nerbil Kilic
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  8. Uwe Güth
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Correspondence to Uwe Güth.

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Moffat, R., de Geyter, C., Myrick, M.E. et al. Young women with breast cancer: how many are actually candidates for fertility preservation?. Arch Gynecol Obstet 286, 1521–1527 (2012). https://doi.org/10.1007/s00404-012-2457-5

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  • DOI: https://doi.org/10.1007/s00404-012-2457-5

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