Abstract
Breast cancer may affect young women who have not yet completed childbearing. Assisted reproductive technology (ART) provides alternatives for fertility preservation such as oocyte, embryo or ovarian tissue cryopreservation. We reviewed the published literature on fertility-preserving management in breast cancer, aiming at finding evidence to answer the following questions: (1) What are the fertility sparing options available?; (2) How do these women respond to IVF? and (3) Can pregnancy influence breast cancer recurrence? There is a paucity of publications describing clinical experience and outcome data which limits accessibility to fertility preservation in this setting. Presently, oocyte or embryo cryopreservation are the main options for fertility preservation. IVF success rates are comparable to the ones of non-oncological populations according to the woman's age but current published studies lack data on definitive success rates following embryo banking for cancer patients. The perception that IVF and pregnancy may worsen cancer prognosis remains, despite the lack of scientific evidence to support this notion. Published studies show reassuring results for pregnancies occurring >2 years after breast cancer diagnosis. The best published evidence suggests pregnancy after breast cancer does not increase the risk of disease recurrence, thus pregnancy should not be forbidden once treatment is completed. Decision making for women diagnosed with cancer requires up-to-date knowledge of the efficacy and safety of available options. Providing consultation with a reproductive specialist and appropriate information on fertility preservation for these women should be an essential aspect of their supportive care.
Highlights
Cancer still represents an enormous global health burden, and published data revealed about 14.1 million new cases and 8.2 million deaths in 2012 worldwide (Torre et al, 2016)
Despite being a major concern of most young patients diagnosed with breast cancer, fertility risks and information about fertility preservation techniques have only been disclosed to the majority of them (68%), but only a small part of the patients (10%) used fertility preservation (Bastings et al, 2014; Ruddy et al, 2014)
To respond to these patients' expectations, the assessment of ovarian reserve should guide the physician in counseling cancer patients about expected success with fertility preservation techniques
Summary
Cancer still represents an enormous global health burden, and published data revealed about 14.1 million new cases and 8.2 million deaths in 2012 worldwide (Torre et al, 2016). The availability of new treatment modalities has improved cancer survival rates over the last two decades, putting quality-of-life issues in the spotlight for women who survive the disease. Fertility care is a growing issue in this setting (Jeruss & Woodruff, 2009; Rowan, 2010). Temporary ovarian suppression with GnRH analogues during chemotherapy is an option in this setting (Rowan, 2010; von Wolff et al, 2015; Lambertini et al, 2015; Lambertini et al, 2016)
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
