Long-Term Considerations for Young Breast Cancer Patients: Fertility, Sexual Health, and Quality of Life

Young patients with breast cancer have unique survivorship needs, including fertility and family planning concerns, complications from iatrogenic menopause, and long-term quality-of-life issues. We aim to summarize the latest data on these side effects of cancer care to guide physicians in providing evidence-based survivorship care for this unique group of patients.

Fertility preservation is safe prior to cancer treatment without any adverse impact on disease-free recurrence or overall survival. Pregnancy after breast cancer can be achieved safely; preliminary data from the POSITIVE trial suggest that endocrine therapy can be safely paused to allow for conception prior to age-related declines in fertility.

Additional research will help us understand controversial topics in survivorship care for young breast cancer patients including safe and effective contraception, use of vaginal estrogen for severe genitourinary syndrome of menopause and pausing anti-estrogen therapy to allow for safe conception, pregnancy, and post-partum care.