title: Young women with breast cancer: how many are actually candidates for fertility preservation?
abstract: OBJECTIVE
  There are no data regarding the actual need for fertility preservation (FP) in breast cancer (BC) patients. Our study provides a practical needs assessment for reproductive medicine by analyzing an unselected cohort of young BC patients. This assessment considers oncological factors as well as the patient's obstetrical and gynecological history and reproductive outcome after BC diagnosis. We aimed to identify how many patients are actually potential candidates for FP and how many patients might consequently use their cryopreserved gametes to achieve pregnancy.
  
  
  METHODS
  Based on a prospective BC database, we analyzed all patients who were ≤40 years at initial diagnosis (time period of diagnosis: 1990-2007; n=100; 7.7% of the entire BC cohort; median age: 35.9 years).
  
  
  RESULTS
  Using an algorithm of exclusion criteria considering disease-specific, therapy-specific and family history characteristics, 36 patients who received chemotherapy were identified as potential "classical" candidates for FP. After 5 years, 22 women were identified as potential candidates for using their cryopreserved gametes to achieve pregnancy; the majority of these patients were childless (n=16, 72.7%) and in their late reproductive years (n=12, 54.5%).
  
  
  CONCLUSIONS
  Our study demonstrates that in a cohort of young BC patients only a minority of women are candidates for FP. Young BC patients who wish to have children in the future usually carry risk factors both from oncological and reproductive medicine perspective. Due to this high-risk profile, the rarity of BC in young age and the limited number of patients who might actually have opted for FP, these women must be offered timely and multidisciplinary counseling in highly specialized centers.
authors: Clinic for Gynecologic Endocrinology and Reproductive Medicine, Women's Hospital, University Hospital Basel (UHB), Spitalstrasse 21, 4031, Basel, Switzerland.
authors: Rebecca
authors: R
authors: Moffat
authors: Christian
authors: C
authors: de Geyter
authors: Mary E
authors: ME
authors: Myrick
authors: Seraina M
authors: SM
authors: Schmid
authors: Christina
authors: C
authors: Sattmann
authors: Sibil
authors: S
authors: Tschudin
authors: Nerbil
authors: N
authors: Kilic
authors: Uwe
authors: U
authors: Güth
mesh_terms: D000328:Adult; D000465:Algorithms; D000970:Antineoplastic Agents / Q000009:adverse effects; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D015925:Cryopreservation; D005191:Family Characteristics; D005260:Female; D059247:Fertility Preservation; D005854:Germ Cells; D006728:Hormones / Q000009:adverse effects; D006801:Humans; D020380:Needs Assessment; D018579:Patient Selection; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000970:Antineoplastic Agents; D006728:Hormones