Are Young Israeli Women with Newly Diagnosed Breast Cancer Adequately Counselled for Risk of Infertility and Premature Menopause?

Introduction

Breast cancer (BC) in women under 50 represents up to 25% of new BC diagnoses. The treatment of BC in women of reproductive age has significant consequences which may include premature menopause (PM) and infertility.

Aim

This is the first study to evaluate whether young Israeli women diagnosed with BC are adequately counselled for risk of infertility and PM.

Methods and Materials

Women ≤45 with newly diagnosed BC at Sheba Medical Centre between July 2012-June 2013 were recruited. Questionnaires addressed reproductive, lifestyle and mental-health issues.

Results

102 women participated. Median age 39 (range 27-45). The 61(60%) that reported that potential infertility was discussed were younger, mean age of 36 vs 40.7 (P<0.0001), with fewer pregnancies (mean 2.5 vs 4.1, p= 0.003), and livebirths (mean 2.1 vs 3.3, p = 0.0001). 71% of women with whom infertility had been discussed expressed concern about infertility. 55(54%) women reported that risk of PM was raised. No patient characteristics were associated with discussion of PM. 93% of women with whom PM had been discussed expressed concern about risk of PM, compared with 59% of women with whom PM had not been discussed (p < 0.0001).

Conclusions

Despite being treated in a dedicated breast unit, many women reported that risks of infertility and PM had not been discussed with them at diagnosis. These issues remained a major source of concern for these women. Initiatives are required to ensure reproductive issues are discussed with all young women with newly diagnosed BC.