Study suggests progress and opportunity for fertility care for young breast cancer patients

RESEARCH SUMMARY

Study Title: Fertility concerns and treatment decision-making among national sample of young women with breast cancer

Publication: Cancer Medicine

Dana-Farber Cancer Institute senior author: Ann Partridge, MD

Summary: Approximately 10% of new breast cancer diagnoses in the U.S. affect women aged 45 years and younger. Treatments can affect fertility through the effects of chemotherapy or by delaying conception. To understand the prevalence of fertility concerns and how they affect treatment decisions, Dana-Farber Cancer Institute researchers analyzed data from the Young and Strong study. The analysis included data and survey responses from a diverse population of 467 women aged 18 to 45 with newly diagnosed breast cancer between 2012 and 2013. They found that 32% of patients had some fertility concerns at the time of treatment decision-making, a lower number than found in other similar studies, possibly because 45% of participants were over 40. The study also found that providers routinely addressed fertility concerns with younger cancer patients. Of those with fertility concerns, 47% indicated the concerns influenced their treatment decisions. Guidelines recommend that providers refer patients to appropriate reproductive specialists, yet only one-fifth of patients concerned about fertility underwent fertility preservation. Race, income, education, community versus academic site, and undergoing neoadjuvant chemotherapy did not predict a patient’s use of fertility preservation strategies.

Impact: While many young women with newly diagnosed breast cancer discuss fertility concerns with their oncologists, few patients pursued fertility preservation, suggesting that patients might face barriers to oncofertility care, including financial or geographic access, lack of referral, or uncertainty. The findings have implications for counseling young patients with breast cancer about their options.

Funding: American Society of Clinical Oncology Conquer Cancer Foundation, Susan G. Komen, Breast Cancer Research Foundation, and the National Institutes of Health.