Abstract ED3-3: Oncofertility and other quality of life issues

Abstract

Abstract The current availability of effective systemic treatment strategies has significantly improved the prognosis of patients with early breast cancer. However, this survival gain is often obtained at the cost of higher toxicity. The increase in life span among breast cancer survivors calls for the need to address both early and late potential adverse effects of anticancer therapies to maximize their quality of life. Among them, the potential gonadotoxicity of anticancer therapies and its implications on fertility and ovarian function need to be discussed with all young patients. According to available guidelines, oncofertility counseling should now be considered mandatory in the care of young women with newly diagnosed cancer. This counselling should focus on the risk of developing treatment-induced premature ovarian insufficiency and on the available techniques to preserve fertility and/or ovarian function. Oocyte/embryo cryopreservation, or ovarian tissue cryopreservation in those not eligible for gamete cryopreservation, are standard strategies to be offered to young patients interested in preserving fertility, i.e. to increase their chances of post-treatment pregnancies. Ovarian suppression with gonadotrophin-releasing hormone agonists (GnRHa) during chemotherapy can be offered to premenopausal patients interested in ovarian function preservation, i.e. to decrease their risk of developing chemotherapy-induced early menopause. Current available data confirm that pregnancy occurring following proper treatment for breast cancer and period of follow-up is safe, both in terms of long-term clinical outcomes for the patients and safety for the babies. However, there is a slightly higher incidence of obstetric and birth complications that require the need for a closer monitoring of these pregnancies. Beyond fertility and pregnancy-related issues, a long-term follow-up of young women with breast cancer by the oncofertility unit is recommended for improving the management of other additional gynecological-related issues faced by these women. Among them, contraception should be considered during active treatment and in the follow-up of women who do not wish to get pregnant. Moreover, in the current era of more complex endocrine therapy approaches with a major negative impact on the quality of life of premenopausal patients with breast cancer, it is essential to properly and proactively care about their treatment-related side effects. Among them, menopause related-symptoms and sexual dysfunction may be better managed by implementing a close collaboration between oncologists and gynecologists within the oncofertility unit. Citation Format: Matteo Lambertini. Oncofertility and other quality of life issues [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr ED3-3.