A quarter of young breast cancer sufferers have reported no discussion of fertility issues at the time of diagnosis, despite the possibility of infertility after treatment, according to new research led by the University of New South Wales (UNSW) in Australia.
"Timing is everything," said Belinda Thewes, a UNSW PhD candidate in the Faculty of Medicine. "These women need more information when they are diagnosed about the effect that treatment could have on their fertility, so they can take appropriate steps to preserve it, if they want to."
The paper notes that breast cancer in women who are childless at diagnosis is becoming more common. Between 6 and 7 percent of those are under 40. The research was published in the Journal of Clinical Oncology.
"Being diagnosed with a potentially life threatening illness is bad enough, but when you're younger there are other factors which need to be considered," said Thewes. "The treatments that are used can affect a woman's fertility and this can be exceptionally distressing, especially for women who may not yet have children, but want to do so."
"When I first started doing this research there were no younger celebrities who were diagnosed with breast cancer," said Thewes, who was based at the Department of Medical Oncology at the Prince of Wales Hospital. "Since then, Kylie Minogue, Belinda Emmett and Jane McGrath have all been diagnosed. These women have raised awareness that young women do get breast cancer and that fertility may be an issue."
The options for younger women who may still want to have children after successful treatment include using IVF prior to chemotherapy and using more experimental techniques such as freezing the woman's ovary tissue. A woman may not become infertile after treatment, but if she does, she may choose to adopt or use donor eggs or embryos.
The study included 228 women who were 40 or younger with a diagnosis of early-stage breast cancer. All completed the questionnaire 6 to 60 months after diagnosis. The paper found that 71 percent of these women had discussed fertility-related information with a health professional, while 86 percent of them discussed menopause.
"While oncologists have extensive knowledge about cancer, they might not have similar levels of knowledge about fertility," said Thewes. "We need to encourage a multidisciplinary approach."
Journal of Clinical Oncology, August 1, 2005
University of New South Wales (http://www.unsw.edu)