Abstract P4-06-26: Fertility Preservation in Young Women with Breast Cancer in Brazil: Patient Profiles and Challenges in a Real World Scenario

Abstract Introduction: Breast cancer, whose incidence among adolescents and young adults (AYA) has increased in recent years, harbors many global challenges and unmet needs. Among them, concerns regarding fertility preservation stand out. Many barriers, such as financial support, lack of timely referral and availability of cryopreservation have been identified, which may be exacerbated in developing countries. In this study, we accessed real-world data regarding fertility preservation in Brazil among AYA breast cancer patients. Methods: This retrospective cross-sectional observational study was conducted in a private referral network cancer center in Brazil. Breast cancer premenopausal patients aged 15 to 39 years undergoing systemic treatment between 2019 and 2023 were identified. Clinical data was obtained retrospectively from medical records. We searched for demographic and clinicopathologic characteristics and data regarding fertility counseling, funding and the practices of fertility preservation groups, aiming to map out the care among this population. Descriptive statistics were used to summarize data. Results: In this cohort, 60 AYA breast cancer patients were identified, representing 10.9% of the disease diagnosis. Of them, 49 (81.6%) underwent chemotherapy, most with anthracycline-containing regimens (82.0%). However, only 23 (38.3%) of the patients had fertility counseling documented in their medical records. Among these referred patients, 12 (52.1%), in fact, proceeded to evaluation by the reproductive medicine team. Oocyte collection for cryopreservation was performed in 7 patients, representing 14.2% under systemic treatment. When this technique was not feasible, some patients (n=3) received LHRH agonists in monotherapy, considered a less effective method. The average time between diagnosis and the initiation of oncologic treatment was also analyzed. Among patients who underwent fertility counseling, it was 25 days (range, 7-34), a similar timeframe to those who did not (19 days, range 3-37). Considering only the patients who underwent oocyte collection, the median time was 26 days (range, 9-34). Regarding fertility preservation funding, procedures and medical expenses were not covered or reimbursed by health insurance but solely by the patient. Conclusion: The present study shows a low rate of cryopreservation among AYA breast cancer patients who underwent systemic treatment in Brazil, although this procedure did not lead to clinically relevant delays in the initiation of chemotherapy. Potential barriers include a poor rate of fertility counseling and funding concerns. Given Brazilian economic and sociodemographic inequalities, this scenario may be even worse in the public setting and outside referral centers. This study highlights the need for standardized protocols to ensure that all AYA patients are counseled on fertility preservation from initial diagnosis. This includes integrating multidisciplinary teams, providing specific training for oncologists and other healthcare professionals and establishing automatic referrals for consultation with fertility specialists. Additionally, providing psychological support is crucial to help patients make informed decisions aligned with their future maternity desires. Thus, further studies would support national cancer care improvements among this population. Citation Format: Caroline Avelar, Renata Arruda Cerqueira, José Tadeu Campos de Avelar, Enaldo Melo de Lima, Rivia Mara Lamaita, João Pedro Costa Apolinário, Ianca Elirrayeth Rocha Mendes, Luísa Lazarino de Souza Campos, Neila Caroline Alves Amaral, Catharina Cançado Avelar, Paulo Henrique Costa Diniz. Fertility Preservation in Young Women with Breast Cancer in Brazil: Patient Profiles and Challenges in a Real World Scenario [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P4-06-26.