One of the main problems affecting young women after adjuvant chemotherapy for early breast cancer is the desire for children and the impact of the treatment on this desire and on pregnancy. Many works are ongoing on fertility preservation but what is the real need ? Hence a survey to evaluate these issues in young breast cancer survivors was put in place.
Patients aged between 18 and 40 years old treated by chemotherapy for non-metastatic breast cancer between 2005 and 2017 were retrospectively asked to respond to this survey, after having signed a consent form.
96 patients were identified, from which 60 agreed and responded to the survey. This high response rate demonstrates the importance of these themes for patients.
Median age at diagnosis was 36 years old (34-40).
Median time between the end of chemo-/radiotherapy and inclusion was of 57 months.
34 patients had node involvement at diagnosis, 10 patients had triple negative tumors.
Adjuvant endocrine therapy was prescribed in 70% of patients from whom 54% were still under treatment at inclusion. Tamoxifen was prescribed in 90% of the cases and complete ovarian suppression for 9.5% of the patients. The mean treatment time was 5 years.
The survey showed that anticancer treatments had a major impact on patients:
Chemotherapy-induced amenorrhea was experienced by 83% of the patients but 86% recovered normal cycles in the following months.
Diagnosis and treatment affected the patients desire for pregnancy: indeed before diagnosis, 31% were hoping to become pregnant; this desire fell to 10% after treatment. However, of these 6 patients: 2 patients became pregnant and 2 miscarried.
Patient’s relationships were affected as 20% declared a change of partner directly or indirectly related to the treatment.
Sexual quality-of-life was impacted in 61% of patients with long-term side effects.
Treatment of breast cancer impacts strongly the quality of life of young breast cancer survivors.
However, definitive amenorrhea related to chemotherapy in these patients occurred in a minority of them and the number of pregnancies reported after treatment is higher than expected if we take into account the desire of pregnancy after treatment.