Abstract P1-10-17: Fertility and other gynaecological concerns in young women treated with chemotherapy for breast cancer between 2003 and 2012
Authors: Mailliez A , Bregegere S , Bonneterre J 
Published: May 2016

2344 patients (pts) younger than 40 years of age have been diagnosed for breast cancer in France in 2012. Almost all were premenopausal and some of them had not completed their family.

We conducted a retrospective study to evaluate the level of information on the impact of breast cancer treatment on fertility.

Patients: We selected breast cancer patients without relapse less than 40 treated in our institution between 2003 and 2012 who received (neo)adjuvant chemotherapy (3FEC100-3 Docetaxel). From 2008, only pts with hormone receptor (HR) negative tumours were considered. HR positive pts were receiving hormonotherapy and thus could not be pregnant. A questionnaire was developed and included 18 items on gynaecologic concerns before and after cancer diagnosis and information on the impact of breast cancer treatment on fertility.

Results: 121 met the inclusion criteria. 64 pts returned the questionnaire (52,8%). Median age at diagnosis was 34,3y (25-39). Before the diagnosis of cancer, 90% were married. 76,6% had at least one child, five of them with assisted reproductive technology. 18,8% wanted a pregnancy at the time of cancer diagnosis. 79,7% had regular menstrual cycles. 78,1% had contraception (oral contraceptive 68%, copper intra uterine device (IUD) 8%, Levonorgestrel-impregnated IUD 19%, condoms 6%).

Only 48,4% considered to be informed on the impact of breast cancer treatment on their fertility and 22 % were addressed to a physician of reproductive medicine. Four patients had fertility preservation.

After cancer treatment, only 14,1% had regular menstruations. 75% had a contraception (oral contraceptive 2%, copper intra uterine device (IUD) 63%, Levonorgestrel-impregnated IUD 4%, tubal ligation 2%, condoms 29%). 35,9% decided not to become pregnant. 16 patients (25%) wished to become pregnant. Seven of them had not received any information neither on the impact of treatment on fertility nor on fertility preservation techniques.

18,8% had a pregnancy (unwanted for 3 patients who requested an abortion) without fertility preservation or assisted reproductive technology. Only 9,4% had at least a live birth.

Several patients complained about chemotherapy-induced premature ovarian failure and the ensuing disturbances such as decreased libido, amenorrhea and menopause.

Conclusion: About 50% of the pts considered not to have received adequate information on fertility and other gynaecological consequences of anti cancer treatment.

This study shows how important gynaecologic considerations are for young breast cancer patients. Information about impact of treatment, fertility preservation techniques and symptoms of premature ovarian failure should be part of the treatment of these patients. Specific time should be devoted during the different consultations before, during and after treatments.

Citation Format: Mailliez A, Bregegere S, Bonneterre J. Fertility and other gynaecological concerns in young women treated with chemotherapy for breast cancer between 2003 and 2012. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-10-17.