Fertility Preservation Options for Young Patients With Breast Cancer

For patients with breast cancer, especially those who are young, discussions around fertility preservation — if they choose to go that route — should be had with their care teams before treatment starts, an expert said.

According to the National Cancer Institute, fertility preservation is a procedure that may help keep a patient’s ability to have children and is often done before treatment that may cause infertility, such as chemotherapy or radiation therapy. Some examples of fertility preservation procedures include egg freezing, fertility-sparing surgery such as removing the cervix (trachelectomy) and in vitro (outside of the body) fertilization with embryo freezing.

At the 2024 ESMO Congress, CURE® sat down with Dr. Ann H. Partridge to learn about strategies for young patients with breast cancer who are interested in preserving their fertility before undergoing treatment. She discussed ovarian suppression, which, according to the American Cancer Society, is when long-acting hormone drugs called gonadotropin-releasing hormone agonists are used to have the woman go into menopause for a short time. This can result in shutting down the ovaries during cancer treatment to reduce the damage done to eggs.

Partridge is interim chair of the Department of Medical Oncology, director of the Adult Survivorship Program and co-founder and director of the Program for Young Adults with Breast Cancer at Dana-Farber Cancer Institute in Boston.

Transcript:

Strategies that can be used to preserve fertility in young breast cancer patients, which are usually female, include the suppression of ovarian function through treatment. This is a strategy that’s somewhat controversial. The data suggest it definitely preserves menopausal status and keeps more women to be premenopausal. The jury is a little more out on whether it actually improves fertility.

I do offer it to patients, but if they’re very interested in fertility preservation, I also want them to do banking eggs or embryos. And those patients typically have to go through stimulation of their ovaries and then a procedure to get the eggs, and then have some of them or all of them fertilized in vitro.

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