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In Breast Cancer, Early Fertility Preservation Referral Better

Referral pre-surgery allows extra cycle of ovarian stimulation before chemotherapy

THURSDAY, Sept. 30 (HealthDay News) -- Referring young, newly diagnosed breast cancer patients to a reproductive specialist before surgery may speed up fertility preservation (FP) procedures and allow time for two cycles of ovarian stimulation (OS) between surgery and initiation of chemotherapy, according to research published online Sept. 27 in the Journal of Clinical Oncology.

Sanghoon Lee, Ph.D., of the New York Medical College in Valhalla, and colleagues conducted a secondary analysis of a prospective database of breast cancer patients undergoing OS by embryo cryopreservation or oocyte for FP. The purpose of the study was to assess whether early referral to reproductive specialists might improve FP, while reducing delay in initiating adjuvant treatment. Ninety-three patients were studied.

Patients referred to a reproductive specialist before breast surgery averaged 42.6 days from diagnosis to initiation of OS, while those referred after surgery had an average of 71.9 days from diagnosis to OS. Time from initial diagnosis to initiation of chemotherapy was also shorter for those who saw a reproductive specialist before versus after surgery (83.9 and 107.8 days, respectively). The researchers found that earlier referral was associated with a significantly greater proportion of patients having time for two FP cycles (25.7 versus 1.7 percent) and resulted in a significantly increased number of oocytes and embryos.

"This is an important finding that may shift the responsibility for these referrals from the medical oncologist to the breast surgeon. Early referral of patients with breast cancer to reproductive specialists before breast surgery is an essential step to increase the likelihood of obtaining a sufficient quantity of oocytes for FP without a delay in breast cancer treatment. Practitioners should adhere to the 2006 FP guidelines issued by the American Society of Clinical Oncology," the authors write.

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