Estimates of Young Breast Cancer Survivors at Risk for Infertility in the U.S.

Background. Standardtreatmentsforbreastcancercanimpair fertility. It is unknown how many U.S. survivors are at risk for infertility. We estimated the population at risk for infertility secondary to treatment among reproductive-aged breast cancer survivors. Methods.Wecombineddatafromthreesources:theNational Program of Cancer Registries (NPCR) and Surveillance, Epidemiology,andEndResultscancerregistrydataonincident breast cancers diagnosed in women aged 15–44 years between 2004 and 2006; treatment data from NPCR’s 2004 Breast and Prostate Cancer Data Quality and Patterns of Care (PoC) study; and data on women’s intentions to have children fromthe2006–2010NationalSurveyofFamilyGrowth(NSFG). Results. In the cancer registry data, an average of 20,308 women with breast cancer aged ,45 years were diagnosed annually.BasedonestimatesfromPoCdata,almostallofthese survivors (97%, 19,416 women) were hormone receptor positive or received chemotherapy and would be at risk for infertility.Thesewomenneedinformationabouttheimpactof treatments on fertility. Estimates based on NSFG datasuggest approximately half of these survivors (9,569 women) might want children and could benefit from fertility counseling and fertility preservation. Conclusion. NearlyallyoungbreastcancersurvivorsintheU.S. areatriskforinfertility.Physiciansshoulddiscussthepotential impactoftreatmentonfertility.Asmallerbutsizeablenumber ofat-risksurvivorsmaybeinterestedinhavingchildren.Given the magnitude of potential infertility and its quality-of-life implications,thesesurvivorsshouldhaveaccesstoandpotential coverageforfertilityservices.TheOncologist2014;19:814–822