title: Fertility and reproductive considerations in premenopausal patients with breast cancer.
abstract: BACKGROUND
  Approximately 10% of all new breast cancer diagnoses occur in young women. Although lacking medical comorbidities, these patients often have unique issues with regard to their reproductive health that merit special consideration. As breast cancer outcomes continue to improve, quality of life for patients and their families after breast cancer treatment has come to the forefront of cancer research, particularly in the growing field of oncofertility.
  
  
  METHODS
  This article reviews the literature on the singular situations and controversies faced by premenopausal breast cancer patients.
  
  
  RESULTS
  Data on amenorrhea and the effects of modern chemotherapeutic agents on amenorrhea are limited, although the role of tamoxifen in amenorrhea is more clearly defined as increasing the rate of amenorrhea across several studies. At the forefront of studies on fertility and premenopausal breast cancer patients are investigations on fertility preservation via ovarian protection and on assisted reproductive technologies. The use of gonadotropin-releasing hormone analogs for ovarian protection remains controversial and continues to be investigated.
  
  
  CONCLUSIONS
  Early integration of assessment and counseling regarding fertility preservation is part of the multidisciplinary approach in the care of the premenopausal breast cancer patient and is key to optimizing both cancer treatment and fertility plans for the future. Because of the many ongoing biological, practical, and ethical controversies surrounding oncofertility, eligible patients should be strongly encouraged to participate in clinical trials and studies to further increase our knowledge in this growing field.
authors.affiliation: H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida 33612, USA. Marie.Lee@moffitt.org
authors.forename: M Catherine
authors.initials: MC
authors.lastname: Lee
authors.forename: Jhanelle
authors.initials: J
authors.lastname: Gray
authors.forename: Hyo Sook
authors.initials: HS
authors.lastname: Han
authors.forename: Shayne
authors.initials: S
authors.lastname: Plosker
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy*; D005260:Female; D005298:Fertility / Q000187:drug effects*; D006801:Humans; D007247:Infertility, Female / Q000139:chemically induced / Q000517:prevention & control*; D017697:Premenopause
chemical_list: D000970:Antineoplastic Agents