Breast Cancer and Fertility: The Latest Evidence

Abstract

Background: Breast cancer is a malignancy affecting a non-negligible percentage of young women population. Thanks to great advances in treatment, the five year survival rate is near 92 %. However, chemotherapy-induced ovarian failure rate is above 20 %. Early referral to a Reproductive Care Center is essential to achieve correct assessment about the effects in fertility of systemic treatments and to decide fertility preservation.

Objective: To collect the current evidence regarding the effect on fertility of breast cancer, the fertility preservation tech- niques, and its influence in cancer prognosis.
Material and methods: Bibliographic literature search through the Pubmed, MedLine, Embase, BioMed Central and SciELO databases.

Conclusions: The gold standard in fertility preservation is oocyte or embryo cryopreservation using letrozole protocols for stimulation. Other techniques like GnRh analogues or ovarian tissue cryopreservation are showing promising results. Neither the use of assisted reproduction techniques or pregnancy has shown to deteriorate the prognosis of breast cancer. In fact, pregnancy after breast cancer appears to have a protective effect in some studies. According to perinatal outcomes, an increased risk of preterm birth and low birth weight has been described.