title: [Adjuvant chemotherapy for breast cancer and fertility: estimation of the impact, options of preservation and role of the oncologist].
abstract: Fifty-two thousand new breast cancers occur each year in France, 7% in patients less than 40 years. The standard regimens of adjuvant chemotherapy for breast cancer now include anthracyclines and taxanes. These therapeutics advances have significantly improved the prognosis of these young women who may later wish to become mother and have biological offspring. The impact of chemotherapy on reproductive function should be accurately assessed and the ovarian reserve has to be taken into account. The estimated risk of chemo-induced amenorrhea and infertility has to be balanced with the expected results and risks of methods of fertility preservation. The place of different options for fertility preservation depends on patient age, presence or not of a partner and the time available before the initiation of treatment. For these breast cancer patients who will receive chemotherapy, new techniques of in vitro oocyte maturation seem promising. Even if some ethical and technical issues are unresolved, fertility preservation must now be part of the management of these young patients receiving adjuvant chemotherapy for breast cancer. This new approach must be multidisciplinary and complex.
authors.affiliation: Centre Oscar-Lambret, département de sénologie, 3, rue Frédéric-Combemale, 59020 Lille Cedex, France. a-mailliez@o-lambret.fr
authors.forename: Audrey
authors.initials: A
authors.lastname: Mailliez
authors.forename: Christine
authors.initials: C
authors.lastname: Decanter
authors.forename: Jacques
authors.initials: J
authors.lastname: Bonneterre
mesh_terms: D000328:Adult; D000367:Age Factors; D000568:Amenorrhea / Q000139:chemically induced; D054304:Anti-Mullerian Hormone / Q000172:deficiency; D000970:Antineoplastic Agents / Q000009:adverse effects; D001943:Breast Neoplasms / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects / Q000379:methods; D015925:Cryopreservation; D005260:Female; D005298:Fertility / Q000187:drug effects*; D006801:Humans; D007247:Infertility, Female / Q000139:chemically induced / Q000517:prevention & control*; D017533:Marital Status; D008495:Medical Oncology; D010053:Ovary / Q000187:drug effects; D010819:Physician's Role; D017410:Practice Guidelines as Topic; D012098:Reproduction / Q000187:drug effects
chemical_list: D000970:Antineoplastic Agents; D054304:Anti-Mullerian Hormone