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 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. Conclusion. 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 accesstoand potential coverage for fertility services.The Oncologist 2014;19:814-822 Implications for Practice: Nearly all young breast cancer survivors are at risk for infertility. Physicians need to discuss infertility effects with these patients prior to treatment. Half of at-risk survivors may wish to have children in the future and may need access to fertility preservation services. Further physician education is needed about the magnitude of infertility and its importance among young breast cancer survivors. Moreover, we need to strengthen the infrastructure so that patients can access fertility preservation services.

Update on fertility preservation in young women undergoing breast cancer and ovarian cancer therapy

“…Thus, attention to fertility concerns is warranted at both diagnosis and follow-up. Many women are interested in maintaining fertility and future reproductive capacity at the time of cancer diagnosis [6,[12][13][14]. Recent estimates suggest that nearly all young survivors with breast cancer in the United States are at risk for infertility [14].…”

“…Many women are interested in maintaining fertility and future reproductive capacity at the time of cancer diagnosis [6,[12][13][14]. Recent estimates suggest that nearly all young survivors with breast cancer in the United States are at risk for infertility [14]. Guidelines recommend that clinicians discuss the potential impact of treatment on fertility and help with fertility preservation decisions among at-risk survivors interested in having children after cancer [15 && -17 && ].…”

Association of tamoxifen use and ovarian function in patients with invasive or pre-invasive breast cancer

“…A greater percentage of premenopausal patients are electing not to receive adjuvant chemotherapy, and there is now evidence supporting more than 5 years of adjuvant tamoxifen [33]. For all these reasons, it is increasingly relevant and important for the 35-50 % of women diagnosed under the age of 45 who desire future childbearing [34] to know whether tamoxifen can directly affect their ability to conceive. Our data suggest that tamoxifen alone is not associated with an earlier age onset of menopause, and that tamoxifen use, in the absence of systemic chemotherapy, is unlikely to significantly accelerate ovarian aging.…”

Embryo Cryopreservation in Breast Cancer Patients

“…Approximately 11 % of all breast cancer cases occur in women <45 years [4]. As almost one quarter of first live births in the United States occur between the ages of 30 and 40, many of these women will have childbearing age [5].…”