Devina K S McCray1, Ashley B Simpson2, Rebecca Flyckt3, Yitian Liu2, Colin O'Rourke4, Joseph P Crowe2, Stephen R Grobmyer2, Halle C Moore5, Stephanie A Valente2. 1. Cleveland Clinic Foundation, Breast Surgical Oncology, Cleveland, OH, USA. devinamccray@gmail.com. 2. Cleveland Clinic Foundation, Breast Surgical Oncology, Cleveland, OH, USA. 3. Cleveland Clinic Foundation, Obstetrics/Gynecology and Women's Health Institute, Cleveland, OH, USA. 4. Cleveland Clinic Foundation, Quantitative Health Services, Cleveland, OH, USA. 5. Cleveland Clinic Foundation, Hematology Oncology, Cleveland, OH, USA.
Abstract
BACKGROUND: Breast cancer is the most frequently occurring cancer in women of reproductive age, and systemic treatments may adversely affect childbearing plans. Use of assisted reproductive technologies and therapies for ovarian protection improve fertility prospects. We evaluated whether patients had a documented fertility discussion (FD) with their oncology physician prior to therapy, what options were chosen, and if pregnancy was achieved. METHODS: A retrospective chart review from 2006 to 2014 was performed to evaluate women aged 40 years and younger who were diagnosed with breast cancer and treated with chemotherapy and/or antihormonal therapy. Patient demographics, treatment regimens, presence or absence of FD, in vitro fertilization (IVF) consultation, gonadotropin-releasing hormone (GnRH) agonist use, and subsequent successful pregnancy were analyzed. RESULTS: Among 303 patients meeting the inclusion criteria, 80 (26 %) had an FD with their physician documented; 71 of these 80 women (89 %) sought further fertility consultation and options. Sixteen (20 %) women were prescribed a GnRH agonist only for ovarian protection during chemotherapy, 50 (63 %) underwent IVF consultation only, and 5 (6 %) had both a GnRH agonist prescribed and an IVF consultation. The overall pregnancy rate was 7 % at a mean of 3 years post breast cancer treatment. Pregnancy after treatment was more common among those pursuing IVF consultation or prescribed a GnRH agonist. CONCLUSIONS: In treating young breast cancer patients, it is important to assess fertility desire, discuss treatment risks relating to fertility, and discuss preservation options. Although not every woman in this group desired pregnancy, 71/80 (89 %) women having a documented FD sought further fertility consultation and options.
BACKGROUND:Breast cancer is the most frequently occurring cancer in women of reproductive age, and systemic treatments may adversely affect childbearing plans. Use of assisted reproductive technologies and therapies for ovarian protection improve fertility prospects. We evaluated whether patients had a documented fertility discussion (FD) with their oncology physician prior to therapy, what options were chosen, and if pregnancy was achieved. METHODS: A retrospective chart review from 2006 to 2014 was performed to evaluate women aged 40 years and younger who were diagnosed with breast cancer and treated with chemotherapy and/or antihormonal therapy. Patient demographics, treatment regimens, presence or absence of FD, in vitro fertilization (IVF) consultation, gonadotropin-releasing hormone (GnRH) agonist use, and subsequent successful pregnancy were analyzed. RESULTS: Among 303 patients meeting the inclusion criteria, 80 (26 %) had an FD with their physician documented; 71 of these 80 women (89 %) sought further fertility consultation and options. Sixteen (20 %) women were prescribed a GnRH agonist only for ovarian protection during chemotherapy, 50 (63 %) underwent IVF consultation only, and 5 (6 %) had both a GnRH agonist prescribed and an IVF consultation. The overall pregnancy rate was 7 % at a mean of 3 years post breast cancer treatment. Pregnancy after treatment was more common among those pursuing IVF consultation or prescribed a GnRH agonist. CONCLUSIONS: In treating young breast cancerpatients, it is important to assess fertility desire, discuss treatment risks relating to fertility, and discuss preservation options. Although not every woman in this group desired pregnancy, 71/80 (89 %) women having a documented FD sought further fertility consultation and options.
Authors: Urvish Jain; Bhav Jain; Oluwadamilola M Fayanju; Fumiko Chino; Edward Christopher Dee Journal: Am J Surg Date: 2022-01-22 Impact factor: 3.125
Authors: Ann H Partridge; Kathryn J Ruddy; William T Barry; Mary L Greaney; Jennifer A Ligibel; Kim M Sprunck-Harrild; Shoshana M Rosenberg; Emily L Baker; J Russell Hoverman; Karen M Emmons Journal: Cancer Date: 2019-02-01 Impact factor: 6.860
Authors: Hazem I Assi; Rasha T Kakati; Rose Mary Attieh; Jessica Khoury; Fares Sukhon; Juliett Berro; Eman Sbaity; Ziad Salem; Arafat Tfayli; Ibrahim A Alameh; Nagi El Saghir Journal: Breast Date: 2020-04-29 Impact factor: 4.380
Authors: Maria Vittoria Dieci; Cristina Ghiotto; Caterina Barbieri; Gaia Griguolo; Carlo Saccardi; Michele Gangemi; Alfonso Pluchinotta; Elisabetta Di Liso; Carlo Alberto Giorgi; Tommaso Giarratano; Giulia Tasca; Grazia Vernaci; Giovanni Faggioni; Pierfranco Conte; Valentina Guarneri Journal: J Womens Health (Larchmt) Date: 2018-07-02 Impact factor: 2.681
Authors: Hikmat N Abdel-Razeq; Razan A Mansour; Khawla S Ammar; Rashid H Abdel-Razeq; Hadil Y Zureigat; Lina M Yousef; Omar A Shahin Journal: Medicine (Baltimore) Date: 2020-03 Impact factor: 1.817