Fertility and breast cancer: A literature review of counseling, preservation options and outcomes

[Display omitted] •Assess and manage fertility issues should be done as early as posible.•Older breast cancer patients (>40) are at greater risk of chemotherapy-induced ovarian failure.•Controlled ovarian stimulation and subsequent oocyte cryopreservation is considered the standard of care.•Pregancy and breastfeeding are both considered to be safe after breast cancer. Fertility preservation is an important issue in breast cancer patients undergoing oncological treatment. Fertility counseling is a crucial need given the physical and psychological stress experienced by patients. Cryopreservation of mature oocytes is currently the standard fertility-preserving procedure. Other options such as ovarian tissue preservation or gonadal protection during chemotherapy are still experimental, but have proven effectiveness. Prompt referral to a fertility unit is highly recommended in order to ensure quality of care. In this article, we focus on the different strategies to preserve fertility in breast cancer patients, assessing also the safety of pregnancy and breastfeeding after cancer. A systemic literature review was performed for research articles published in English in PubMed, or as abstracts from the European Society for Medical Oncology (ESMO), San Antonio Breast Cancer Symposium (SABCS) and American Society of Clinical Oncology (ASCO) annual meetings, using the search terms “breast cancer” and “fertility".