J Breast Cancer.  2023 Jun;26(3):221-242. 10.4048/jbc.2023.26.e28.

Fertility Preservation in Young Women With Breast Cancer: A Review

Affiliations
  • 1Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
  • 2Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
  • 3Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
  • 4Cancer Research Institute, Seoul National University, Seoul, Korea
  • 5Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
  • 6Division of Breast Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
  • 7Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
  • 8Division of Breast Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Abstract

Fertility preservation is a major concern in young patients diagnosed with breast cancer and planning to receive multimodality treatment, including gonadotoxic chemotherapy with or without age-related decline through long-term endocrine therapy. Most breast cancer patients undergo multimodality treatments; many short-term and long-term side effects arise during these therapies. One of the most detrimental side effects is reduced fertility due to gonadotoxic treatments with resultant psychosocial stress. Cryopreservation of oocytes, embryos, and ovarian tissue are currently available fertility preservation methods for these patients. As an adjunct to these methods, in vitro maturation or gonadotropinreleasing hormone agonist could also be considered. It is also essential to communicate well with patients in the decision-making process on fertility preservation. It is essential to refer patients diagnosed with breast cancer on time to fertility specialists for individualized treatment, which may lead to desirable outcomes. To do so, a multimodal team-based approach and in-depth discussion on the treatment of breast cancer and fertility preservation is crucial. This review aims to summarize infertility risk related to currently available breast cancer treatment, options for fertility preservation and its details, barriers to oncofertility counseling, and psychosocial issues.

Keyword

Breast Neoplasms; Cancer Survivors; Fertility Preservation; Pregnancy
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