Abstract
Many young women diagnosed with breast cancer will be confronted with premature ovarian insufficiency and infertility as a consequence of systemic therapies used to treat their cancer. This is a concern for nearly half of young women diagnosed with breast cancer. We will review the impact of breast cancer chemotherapy, endocrine therapy, and immunotherapy on fertility and surrogate markers of fertility. Modern breast cancer treatments continue to have an impact on a woman’s fertility potential. This risk is reduced as more patients are able to safely eliminate chemotherapy as part of their treatment plan without compromising cancer-related outcomes. Research is being done to assess whether patient outcomes are affected from pausing endocrine therapy to allow for pregnancy. With varying extent, most breast cancer treatments have some impact on fertility although more data is necessary. Individualized fertility counseling is an important aspect of comprehensive cancer care. This review highlights the special population of premenopausal breast cancer patients and the challenge in their care should they desire children.
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