Fertility counseling of young breast cancer patients

Matteo Lambertini, Paola Anserini, Alessia Levaggi, Francesca Poggio, Lucia Del Mastro

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Approximately 6% of women with breast cancer are diagnosed before the age of 40. Young age is an independent predictor of adverse outcome and most young breast cancer patients receive systemic treatment with chemotherapy, hormonal therapy or both. The loss or impairment of fertility is a potential side effect of antineoplastic treatments. Due to the rising trend to delaying pregnancy in life, an increasing proportion of young cancer patients who are yet to have a pregnancy will face the problem of iatrogenic menopause in the future. The incidence of anticancer-treatment-related ovarian failure depends on the type of chemotherapy regimen administered, the use of tamoxifen and the age of patients. It rises with increasing age, in the range of 22-61% and 61-97% in women aged 40 years respectively. Although there is a clear trend to increasing incidence of ovarian failure with the rise in aging, there may be a small proportion of patients who became amenorrhoeic despite the very young age, thus indicating that also individual factors still unknown may affect the probability of treatment-related ovarian failure. A prompt referral of patients to reproductive counseling and a multidisciplinary team including Oncology and Reproductive Units are essential to face the management of fertility issues in cancer patients. Fertility counseling should include a detailed description of all the available techniques to preserve fertility. The main available fertility preservation techniques, standard and experimental, for young breast cancer patients include: temporary ovarian suppression during chemotherapy with gonadotropin-releasing hormone analogues, embryo cryopreservation, cryopreservation of oocytes and cryopreservation of ovarian tissue. Research efforts are still necessary to improve the efficacy and safety of the available fertility preservation strategies as well as an efficient collaboration between oncologists and gynecologists is necessary to improve patients' access to the strategies themselves

Original languageEnglish
JournalJournal of Thoracic Disease
Volume5
Issue numberSUPPL.1
DOIs
Publication statusPublished - 2013

Fingerprint

Fertility
Counseling
Breast Neoplasms
Cryopreservation
Fertility Preservation
Drug Therapy
Therapeutics
Pregnancy
Incidence
Tamoxifen
Menopause
Gonadotropin-Releasing Hormone
Antineoplastic Agents
Oocytes
Neoplasms
Referral and Consultation
Embryonic Structures
Safety
Research

Keywords

  • Breast cancer
  • Counseling
  • Fertility preservation

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Fertility counseling of young breast cancer patients. / Lambertini, Matteo; Anserini, Paola; Levaggi, Alessia; Poggio, Francesca; Mastro, Lucia Del.

In: Journal of Thoracic Disease, Vol. 5, No. SUPPL.1, 2013.

Research output: Contribution to journalArticle

Lambertini, Matteo ; Anserini, Paola ; Levaggi, Alessia ; Poggio, Francesca ; Mastro, Lucia Del. / Fertility counseling of young breast cancer patients. In: Journal of Thoracic Disease. 2013 ; Vol. 5, No. SUPPL.1.
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