title: Estimates of young breast cancer survivors at risk for infertility in the U.S.
abstract: BACKGROUND
  Standard treatments for breast cancer can impair fertility. It is unknown how many U.S. survivors are at risk for infertility. We estimated the population at risk for infertility secondary to treatment among reproductive-aged breast cancer survivors.
  
  
  METHODS
  We combined data from three sources: the National Program of Cancer Registries (NPCR) and Surveillance, Epidemiology, and End Results cancer registry data on incident breast cancers diagnosed in women aged 15-44 years between 2004 and 2006; treatment data from NPCR's 2004 Breast and Prostate Cancer Data Quality and Patterns of Care (PoC) study; and data on women's intentions to have children from the 2006-2010 National Survey of Family Growth (NSFG).
  
  
  RESULTS
  In the cancer registry data, an average of 20,308 women with breast cancer aged <45 years were diagnosed annually. Based on estimates from PoC data, almost all of these survivors (97%, 19,416 women) were hormone receptor positive or received chemotherapy and would be at risk for infertility. These women need information about the impact of treatments on fertility. Estimates based on NSFG data suggest approximately half of these survivors (9,569 women) might want children and could benefit from fertility counseling and fertility preservation.
  
  
  CONCLUSIONS
  Nearly all young breast cancer survivors in the U.S. are at risk for infertility. Physicians should discuss the potential impact of treatment on fertility. A smaller but sizeable number of at-risk survivors may be interested in having children. Given the magnitude of potential infertility and its quality-of-life implications, these survivors should have access to and potential coverage for fertility services.
authors.affiliation: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA; ICF International, Rockville, Maryland, USA; Dana-Farber Cancer Institute, Boston, Massachusetts, USA; Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Reproductive Medicine and Laboratory of Fertility Preservation and Molecular Reproduction, New York Medical College, Valhalla, New York, USA; Innovation Institute for Fertility Preservation, New York, New York, USA fph1@cdc.gov.
authors.forename: Katrina F
authors.initials: KF
authors.lastname: Trivers
authors.affiliation: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA; ICF International, Rockville, Maryland, USA; Dana-Farber Cancer Institute, Boston, Massachusetts, USA; Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Reproductive Medicine and Laboratory of Fertility Preservation and Molecular Reproduction, New York Medical College, Valhalla, New York, USA; Innovation Institute for Fertility Preservation, New York, New York, USA.
authors.forename: Aliza K
authors.initials: AK
authors.lastname: Fink
authors.affiliation: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA; ICF International, Rockville, Maryland, USA; Dana-Farber Cancer Institute, Boston, Massachusetts, USA; Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Reproductive Medicine and Laboratory of Fertility Preservation and Molecular Reproduction, New York Medical College, Valhalla, New York, USA; Innovation Institute for Fertility Preservation, New York, New York, USA.
authors.forename: Ann H
authors.initials: AH
authors.lastname: Partridge
authors.affiliation: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA; ICF International, Rockville, Maryland, USA; Dana-Farber Cancer Institute, Boston, Massachusetts, USA; Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Reproductive Medicine and Laboratory of Fertility Preservation and Molecular Reproduction, New York Medical College, Valhalla, New York, USA; Innovation Institute for Fertility Preservation, New York, New York, USA.
authors.forename: Kutluk
authors.initials: K
authors.lastname: Oktay
authors.affiliation: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA; ICF International, Rockville, Maryland, USA; Dana-Farber Cancer Institute, Boston, Massachusetts, USA; Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Reproductive Medicine and Laboratory of Fertility Preservation and Molecular Reproduction, New York Medical College, Valhalla, New York, USA; Innovation Institute for Fertility Preservation, New York, New York, USA.
authors.forename: Elizabeth S
authors.initials: ES
authors.lastname: Ginsburg
authors.affiliation: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA; ICF International, Rockville, Maryland, USA; Dana-Farber Cancer Institute, Boston, Massachusetts, USA; Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Reproductive Medicine and Laboratory of Fertility Preservation and Molecular Reproduction, New York Medical College, Valhalla, New York, USA; Innovation Institute for Fertility Preservation, New York, New York, USA.
authors.forename: Chunyu
authors.initials: C
authors.lastname: Li
authors.affiliation: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA; ICF International, Rockville, Maryland, USA; Dana-Farber Cancer Institute, Boston, Massachusetts, USA; Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Reproductive Medicine and Laboratory of Fertility Preservation and Molecular Reproduction, New York Medical College, Valhalla, New York, USA; Innovation Institute for Fertility Preservation, New York, New York, USA.
authors.forename: Lori A
authors.initials: LA
authors.lastname: Pollack
mesh_terms: D000293:Adolescent; D000328:Adult; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D005260:Female; D059247:Fertility Preservation; D006801:Humans; D007247:Infertility, Female / Q000139:chemically induced / Q000453:epidemiology / Q000473:pathology*; D017741:Survivors; D014481:United States
keywords: Breast neoplasms; Fertility preservation; Infertility; Pregnancy; Reproductive behavior; Survivors