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Preserving Fertility for Breast Cancer Patients

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a blog by David Kreiner, M.D., F.A.C.O.G., East Coast Fertility, February 22, 2011

Today, women living with breast cancer become fertility patients.

Historically, women with breast cancer were thought to lose much of their sexuality, including their roles as lovers, and their ability to get pregnant and become a lactating mother. Breast cancer treatment was aimed at aggressive resection of the cancer, with surgery that traditionally included a total mastectomy (if not bilateral) and sometimes included disfiguring lymph node dissection. Postoperative chemotherapy was effective, but resulted in suppression of ovulation and pregnancy.

Given the choice between potential survival with total mastectomies or preservation of the breast, most surgeons and their patents have opted for the surer path to preservation of life, which meant undergoing aggressive and often radical surgery. Future fertility was not a right these women could claim lest they increased their risk that the disease would spread if they significantly delayed chemotherapy.

Happily, recent events have radically changed medicine's approach to women living with breast cancer. The latest studies indicate that resections of localized tumors have the same survival rates as total mastectomies, thus a woman with breast cancer may not need to undergo the mastectomy which can drastically alter her body image. In addition, reproductive technology can now offer egg freezing and embryo freezing so that we can now safely preserve her fertility as well.

These advances mean women with breast cancer need no longer feel defined by the disease. Modern conservative surgery, combined with egg or embryo freezing (prior to initiating chemotherapy or prior to oophorectomies removing the native source of estrogen), allows these women to maintain a positive body image and preserve their fertility for the day when their breast cancer can take second place to their fertility and childbearing needs.

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