Fertility procedures did not delay breast cancer treatment in young women

Women who are aged younger than 40 and have been diagnosed with breast cancer may seek fertility treatment without significantly delaying their cancer treatment, according to the results of a retrospective study.

Because many breast cancer treatment options may permanently damage a woman’s fertility, a referral to a reproductive endocrinologist is often advised; however, concerns about treatment delays for the cancer diagnosis may influence physician or patient decisions regarding fertility preservation procedures, according to the study’s background information.

This retrospective study, conducted using data from the Stanford Cancer Center tumor registry, found that there was little delay in the treatment of woman who opted to undergo oocyte retrieval and embryo cryopreservation compared with those women who did not.

Eighty-two women aged younger than 40 who received adjuvant chemotherapy for breast cancer were identified. Of the women, 19 underwent ovarian stimulation and oocyte retrieval and 63 did not. The researchers then compared the timing of fertility preservation, surgical intervention and chemotherapy to the time intervals between diagnosis and treatment in patients who did not undergo fertility preservation.

The mean age of women in the fertility preservation group was 33.7 years compared with 35.2 years in the non-fertility group. The median time from initial diagnosis to chemotherapy in women who underwent fertility preservation was 71 days vs. 67 days among those who did not. The median time interval from definitive operation to chemotherapy was similar in the two groups: 30 days for women undergoing fertility preservation and 29 days for women in the control group.

The researchers noted that the two groups were dissimilar with respect to stage of disease: 47.3% of patients in the fertility preservation group had node-negative disease compared with 25.4% of patients in the control group. Furthermore, 73.7% of the fertility preservation group had ER-positive tumors compared with 65.1% of the control group.

Baynosa J. J Am Coll Surg. 2009;209:603-607.

Fertility preservation is of immense importance to young people with hematological/oncologic conditions prior to chemo/radiotherapy. Various cryopreservation, transplantation and in vitro fertilization techniques have emerged to be used for fertility preservation and restoration in the last decade, and all potential patients should be made aware of those options.

– Kutluk Oktay, MD, FACOG
Medical Director, Institute for Fertility Preservation