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- Title
Counseling young women with early breast cancer on fertility preservation.
- Authors
ter Welle-Butalid, M. E. (Elena); Vriens, I. J. H. (Ingeborg); Derhaag, J. G. (Josien); Leter, E. M. (Edward); de Die-Smulders, C. E. (Christine); Smidt, M. (Marjolein); van Golde, R. J. T. (Ron); Tjan-Heijnen, V. C. G. (Vivianne)
- Abstract
Purpose: Women with early-stage breast cancer may still have a future child wish, while chemotherapy may impair fertility. To pursue on fertility preservation shortly after breast cancer diagnosis is complex. This review holds a critical reflection on all topics that need to be counseled to give them the opportunity to make a well-informed decision before starting any oncological treatment. Methods: A comprehensive literature review was performed on papers published in English language on breast cancer in young women, risk of chemotherapy-induced infertility, fertility preservation techniques, impact of possible mutation carriership, and future pregnancy outcome. Results: Below 40 years of age, the risk of permanent chemotherapy-induced ovarian function failure is approximately 20%, where taxanes do not significantly add to this risk. Overall, 23% of reported women who performed fertility preservation by cryopreserving oocytes or embryos returned for embryo transfer. Of these, 40% gave live birth. Both fertility preservation in women diagnosed with breast cancer and pregnancy after treatment seem safe with respect to breast cancer survival. Women who have a genetic predisposition for breast cancer like BRCA gene mutation should also be informed about the possibility of pre-implantation genetic diagnosis. Conclusions: Women with an early stage of breast cancer and a possible future child wish should be referred to an expertise center in breast cancer, fertility preservation, and genetics in this complex decision-making process, shortly after diagnosis.
- Subjects
FERTILITY preservation; BREAST cancer; FERTILITY; BRCA genes; EMBRYO transfer; YOUNG women; CANCER diagnosis
- Publication
Journal of Assisted Reproduction & Genetics, 2019, Vol 36, Issue 12, p2593
- ISSN
1058-0468
- Publication type
Article
- DOI
10.1007/s10815-019-01615-6