Ann H. Partridge, MD, MPH

Ann H. Partridge, MD, MPH, talks about how fertility preservation can positively impact the psychosocial health in patients with breast cancer.

Though LHRH agonists may be the preferred method of ovarian function suppression, ovarian ablation is a viable option for select premenopausal breast cancer patients.

In this interview we discuss the causes of treatment-related infertility as well as strategies to preserve fertility in patients treated for their breast cancer.

With the presentation and publication of the TEXT and SOFT trials in 2014, along with the aTTom and ATLAS trials in the last few years, deciding among the standard adjuvant endocrine therapy options for premenopausal women with hormone-sensitive breast cancer has become increasingly complicated.

Ahead of the 2014 ASCO Breast Cancer Symposium we discussed genetic and environmental risk factors for breast cancer, as well as interventions that can reduce a patient’s risk.

Breast cancer is the leading cause of cancer-related deaths in young women, and survival rates for young women with breast cancer are lower than for older women with breast cancer. This inferior survival is seen in spite of the fact that younger women often receive more aggressive therapy, as detailed in Dr. Peppercorn’s thoughtful review.[1]

The optimal endocrine therapy for premenopausal women with hormone receptor–positive early breast cancer remains elusive. Dr. Pritchard presents a thoughtful review of this important topic, including the historic context for the current controversy regarding the utility of ovarian suppression (either by medication or permanent ablation) in the adjuvant treatment of young women with breast cancer.

The relationship between pregnancy and breast cancer is complex,and a paucity of available data further complicates decision-makingfor many women diagnosed with breast cancer during pregnancy ordesiring to become pregnant after such a diagnosis. Treatment of breastcancer during pregnancy requires a multidisciplinary care team andcareful consideration of the risk of the disease and gestational age ofthe fetus, in conjunction with the patient’s preferences. Chemotherapyshould be deferred beyond the first trimester. There is no evidence thatpregnancy in a breast cancer survivor will decrease long-term survival;in fact, studies suggest a potential protective effect of pregnancy afterbreast cancer in terms of the risk of recurrence. However, the availablestudies are limited by substantial potential biases, and concerns remainfor some women and their doctors about the risks of pregnancy afterbreast cancer. This article reviews what is known about the associationbetween pregnancy and breast cancer, discusses treatment options forwomen diagnosed with the disease during pregnancy, and summarizesevidence regarding the safety of pregnancy after breast cancer.