Appropriate to consider and discuss fertility and family planning with premenopausal women before they undergo breast cancer treatment.
Context
A substantial proportion of women in Australia are diagnosed with breast cancer prior to menopause. In 2016, it is estimated that there will be 5,035 new cases (32%) of breast cancer in women aged 20-54 years.
Some treatments for breast cancer, including chemotherapy and hormone therapy, may induce premature menopause and lead to impaired fertility. This can impact on a woman’s chance of having children in the future.
Value to patients
Before the commencement of treatment, it is important to discuss the potential impacts on fertility, as well as the options for preserving fertility to increase the likelihood of future childbearing. This will provide women with an opportunity to consider their fertility preservation options as part of their breast cancer treatment considerations.
Supporting evidence
Australian Institute of Health and Welfare 2012. Cancer incidence projections, Australia 2011 to 2020. Cancer series no. 66. Cat. no. CAN 62. Canberra: AIHW.
Deshpande NA, Braun IM, Meyer FL. Impact of fertility preservation counseling and treatment on psychological outcomes among women with cancer: A systematic review. Cancer. 2015;121(22):3938-47.
Letourneau JM, Ebbel EE, Katz PP, et al. Pretreatment fertility counseling and fertility preservation improve quality of life in reproductive age women with cancer. Cancer. 2012;118(6):1710-7.
Peate M, Meiser B, Cheah BC, et al. Making hard choices easier: a prospective, multicentre study to assess the efficacy of a fertility-related decision aid in young women with early-stage breast cancer. British Journal of Cancer 2012;106(6):1053-61.
Ruddy KJ, Gelber SI, Tamimi RM, et al. Prospective study of fertility concerns and preservation strategies in young women with breast cancer. Journal of Clinical Oncology. 2014;32(11):1151-6.