Fertility options in young breast cancer survivors: a review of the literature.
OBJECTIVE
To describe the impact of treatment on fertility, discuss fertility-sparing options available for women with breast cancer, and explore pregnancy subsequent to breast cancer.


METHODS
Published research, clinical articles, book chapters, and abstracts.


RESULTS
The risk of amenorrhea associated with alkylating agents in breast cancer survivors is well known. Fertility-sparing options before, during, and after treatment are possible with the use of assistive reproductive technology. Young breast cancer survivors are concerned about stimulating recurrence with subsequent pregnancy, health during pregnancy, and family matters.


CONCLUSIONS
Current data about the effects of treatment on amenorrhea, subsequent pregnancy after treatment, preservation of ovarian function during adjuvant therapy, and management of ovarian failure in young women with breast cancer are important to include in discussions and counseling.


CONCLUSIONS
Young women deserve a thoughtful discussion about their concerns among their multidisciplinary team, including oncology nurses, oncologists, and social workers. Effects of treatment on fertility are well known. Women with fertility concerns should be referred to a reproductive endocrinology team at the time of diagnosis rather than after treatment has ended.
Dow
Karen Hassey
KH
School of Nursing, College of Health and Public Affairs, University of Central Florida, FL, USA. kdow@mail.ucf.edu
Kuhn
Deanna
D
D000328:Adult; D000568:Amenorrhea / Q000139:chemically induced; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000150:complications* / Q000451:nursing / Q000628:therapy*; D003376:Counseling / Q000379:methods*; D015925:Cryopreservation / Q000379:methods; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D004624:Embryo Transfer; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000451:nursing* / Q000517:prevention & control*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011878:Radiotherapy / Q000009:adverse effects; D012307:Risk Factors
D003520:Cyclophosphamide