title: Prospective study of fertility concerns and preservation strategies in young women with breast cancer.
abstract: OBJECTIVE
  Most research regarding fertility in young women with breast cancer has focused on long-term survivors. Little is known about how fertility concerns affect treatment decisions or fertility preservation strategies at the time of initial cancer diagnosis.
  
  
  METHODS
  As part of an ongoing prospective multicenter cohort study, we surveyed women with newly diagnosed early-stage breast cancer at age ≤ 40 years. The baseline survey included sociodemographic, medical, and treatment data as well as a modified Fertility Issues Survey, including fertility concern and preservation items. Univariable and multivariable modeling were used to investigate predictors of greater fertility concern.
  
  
  RESULTS
  Among the first 620 eligible respondents included in this analysis, median age was 37 years (range, 17 to 40 years); 425 women (68%) discussed fertility issues with their physicians before starting therapy, and 319 (51%) were concerned about becoming infertile after treatment. Because of concerns about fertility, four women (1%) chose not to receive chemotherapy, 12 (2%) chose one chemotherapy regimen over another, six (1%) considered not receiving endocrine therapy, 19 (3%) decided not to receive endocrine therapy, and 71 (11%) considered receiving endocrine therapy for < 5 years; 65 (10%) used fertility preservation strategies. Greater concern about fertility was associated with younger age, nonwhite race, not having children, and receipt of chemotherapy.
  
  
  CONCLUSIONS
  Many young women with newly diagnosed breast cancer have concerns about fertility, and for some, these substantially affect their treatment decisions. Only a minority of women currently pursue available fertility preservation strategies in this setting.
authors.affiliation: Kathryn J. Ruddy, Shari I. Gelber, Meghan E. Meyer, and Ann H. Partridge, Dana-Farber Cancer Institute; Rulla M. Tamimi and Elizabeth S. Ginsburg, Brigham and Women's Hospital; Lidia Schapira, Massachusetts General Hospital; Steven E. Come, Beth Israel Deaconess Medical Center, Boston, MA; and Virginia F. Borges, University of Colorado Denver, Aurora, CO.
authors.forename: Kathryn J
authors.initials: KJ
authors.lastname: Ruddy
authors.forename: Shari I
authors.initials: SI
authors.lastname: Gelber
authors.forename: Rulla M
authors.initials: RM
authors.lastname: Tamimi
authors.forename: Elizabeth S
authors.initials: ES
authors.lastname: Ginsburg
authors.forename: Lidia
authors.initials: L
authors.lastname: Schapira
authors.forename: Steven E
authors.initials: SE
authors.lastname: Come
authors.forename: Virginia F
authors.initials: VF
authors.lastname: Borges
authors.forename: Meghan E
authors.initials: ME
authors.lastname: Meyer
authors.forename: Ann H
authors.initials: AH
authors.lastname: Partridge
mesh_terms: D000293:Adolescent; D000328:Adult; D001943:Breast Neoplasms / Q000523:psychology* / Q000628:therapy*; D003120:Colorado; D003657:Decision Making; D005260:Female; D059247:Fertility Preservation; D006801:Humans; D007247:Infertility, Female / Q000517:prevention & control*; D008404:Massachusetts; D010817:Physician-Patient Relations; D011446:Prospective Studies; D012307:Risk Factors