Desire for pregnancy and fertility preservation in Japanese patients with breast cancer

Abstract

Abstract Purpose Data on the desire for pregnancy and the status of fertility preservation (FP) in patients with breast cancer remains unclear. This study aimed to determine the status of patients with breast cancer under 43 years of age who desired pregnancy and FP implementation before systemic therapy.Methods This retrospective study surveyed the institutional clinical databases and electronic medical records of patients < 43 years with stage 0-III primary breast cancer at the time of surgery and treated between April 2020 and March 2021. All patients were enquired about their desire for pregnancy in a questionnaire by ‘present,’ ‘absent,’ and ‘unsure’ at their first visit. The correlation between the desire for pregnancy, FP, and clinicopathological factors was investigated.Results Among 1,005 patients who underwent surgery for primary breast cancer, 146 were included in the analysis. Thirty-four patients (23.3%) had a desire for pregnancy, and 45 patients (30.8%) chose ‘unsure’. Factors associated with the desire for pregnancy were younger age at the time of surgery (p < 0.0022), unmarried status (p < 0.001), nulliparity (p < 0.001), early-stage disease (p = 0.0016), and estrogen receptor positivity (p = 0.008). Among 115 patients who underwent systemic therapy, 13 patients (11.3%) implemented FP prior to systemic therapy. Patients who were nulliparous implemented FP more often (p = 0.0195). The FP rate was lower in patients who received neoadjuvant chemotherapy (p = 0.0863).Conclusions Our study suggests that unmarried, nulliparous, and younger patients were more interested in pregnancy, and nulliparous patients more often implemented FP.