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New fertility resource for young women with breast cancer

Media releases 17 Apr 2012

New fertility resource for young women with breast cancer

An Australian study, recently published in the British Journal of Cancer, has supported the widespread use of decision aids to help young women recently diagnosed with early breast cancer to make decisions about fertility.

The joint study, involving researchers from a number of Australian universities and hospitals, found that fertility information is a high priority for young women newly diagnosed with breast cancer but that until recently the information has been largely inadequate.

The study, led the University of New South Wales (UNSW), followed the development of a new booklet, Fertility-related Choices: A Decision Aid for Younger Women with Early Breast Cancer. 

Health care professionals are encouraged to seek out the free resource and use it to help start a discussion about fertility with their patients. 

The booklet is a unique collaboration between UNSW, McGrath Foundation and Breast Cancer Network Australia (BCNA).  The McGrath Foundation has funded the printing of the booklet, while BCNA is distributing the resource to health professionals.

Maxine Morand, BCNA CEO, said that fertility concerns are often overlooked by health professionals when younger women are diagnosed with breast cancer or undergoing treatment, despite this being an issue of huge importance to individual women. 

“Around 3-7% of women with early-stage breast cancer are under 40 years of age at diagnosis.  Most women receive chemotherapy as part of their treatment, which is often associated with reduced fertility,” Ms Morand said. 

“Younger women diagnosed with early breast cancer need to make decisions quickly about their fertility, and whether they would like to pursue fertility preservation measures.  This decision needs to be made before beginning chemotherapy.”

Ms Morand said that young women needed to be better supported and informed when reaching decisions about fertility. 

“There are a number of methods for preserving fertility and if newly diagnosed breast cancer patients are planning to become pregnant in the future, or even if they haven't given children much thought, it’s important for them to consider some of these options before they start cancer treatment.”

Ms Morand said the new booklet would help health professionals better navigate this often complicated issue with their younger breast cancer patients. 

“We know that fertility is an extremely important issue for younger women newly diagnosed with breast cancer but in the past information available was often inadequate,” she said. 

“This fantastic resource will help professionals to broach this issue with their patients and help ensure younger women are provided clear and current information about their fertility choices soon after diagnosis.”

The booklet contains information about breast cancer treatment, how it can affect fertility, and fertility options to consider.  It may be helpful to health professionals working with young women who have:

  • recently been diagnosed with early breast cancer
  • are still of reproductive age (having regular periods and no menopausal symptoms)
  • are thinking of starting a family or having more children in the future.

Dr Michelle Peate, currently the Research Programme Manager at the Psycho-Oncology Co-operative Research Group (PoCoG) at the University of Sydney, led the team of researchers looking into the effectiveness of a fertility-related decision aid while based at the Psychosocial Research Group at UNSW.

Dr Peate and her colleagues said their findings supported the widespread use of the decision aid among younger breast cancer patients who have not completed their families. 

“The impact of chemotherapy and hormone therapy may reduce a woman’s fertility and chance of having children in the future. There are a number of factors which contribute to this issue, including a woman’s age, and the type of treatment she has and how it affects her ovaries,” Dr Peate explained.  

“Our study supported the widespread use of the Fertility-related Choices decision aid among younger breast cancer patients who have not completed their families to assist with understanding the impact of cancer on fertility and the options available to improve the chances of a future pregnancy.  We found the decision aid should be used shortly after diagnosis and before chemotherapy is started.”

Methods for preserving fertility include mature egg freezing, embryo freezing, ovarian tissue freezing, medications and using a donor egg.

Dr Julie Thompson, BCNA’s Clinical Advisor said; “Fertility is a crucial issue for younger women recently diagnosed with breast cancer and should be routinely addressed by health professionals as part of the clinical treatment of breast cancer.”

BCNA’s fertility decision aid is available for download through BCNA's website or a hard copy can be obtained by calling 1800 500 258.

A young woman’s experience with breast cancer and fertility

Married with a toddler, Genya Miller and her husband were hoping to add to their little family.  Then in the middle of their expansion plans, Genya found a lump which turned out to be breast cancer.  Genya was only 32.  She was told she would need surgery, chemotherapy and radiation followed by five years of hormonal treatment:

“When my doctor phoned with my diagnosis, the first question I asked was ‘Will I lose my hair?’ to which she said yes.  My second question was ‘We’re trying for another baby.  Does this mean I won’t be able to have another child?’  She replied, ‘Genya, I can’t answer that’.

Throughout the whirlwind of medical appointments over the next month, I kept asking how my breast cancer diagnosis would impact on my fertility.  My oncologist told me I was lucky because I already had a child.  No one would, or could, give me the information on the one thing I so desperately needed to know. 

We decided not to harvest eggs as my cancer was oestrogen positive.  It was all too hard.  I couldn’t get the answers I needed to make an informed decision so we decided to leave it all to chance.

I wish this resource had been available when I was diagnosed.  I spent hours googling and trawling through internet sites looking for the very information in the Fertility Choices decision aid. 

No one can tell you what impact your treatment will have on your fertility, it is important that young women go into their fight armed with this valuable information to make informed decisions.

Many doctors deal with breast cancers as an ‘old lady’ disease.  For us younger sufferers, it is a very lonely path - as the medical community often ignores the fact that younger women diagnosed with breast cancer are also in their child bearing years.

The medical profession saw me as a cancer patient fighting for her life. I needed answers and hope for my life after breast cancer.”

A full version of Genya’s story is available upon request. 

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