Many women with early breast cancer will benefit from chemotherapy after surgery but are afraid to risk the opportunity of child-bearing. The likelihood of amenorrhea depends on the type of chemotherapy drugs and regimen used. The chance of menopause is higher in patients who are 40 years and above. With currently used chemotherapy regimen in breast cancer, the incidence of amenorrhea ranges from 34% to 61% in women less than 40 years old and increases to 90% in women more than 40 years of age. Some women may regain menstrual function within a year after a temporary pause. For a majority of those who are less than 40 years of age, fertility is not compromised, however it is important to discuss this issue with your treating physician.

While it is true that chemotherapy may reduce bone mineral density (BMD), there is no evidence yet to suggest an increased risk of hip or spine fractures in the long term. Low BMD may pre-dispose a patient to osteoporosis but many agents are available to slow down the natural decline in BMD. They include bisphosphonates, calcium and vitamin D supplements. Raloxifene is a drug similar to tamoxifen that is useful in preventing osteoporosis. Tamoxifen’s role in osteoporosis prevention is not established. BMD may be assessed using special scans. Do consult your doctor about preventive options and the need for special bone scans if you are concerned about risk of osteoporosis.

In conclusion, most young women preserve their fertility after chemotherapy and the risk of osteoporosis may be reduced with effective preventive treatment.