Summary of best evidence on fertility preservation decision-making for breast cancer patients of reproductive age

ZHANG Siying; ZHONG Minhui; LIU Xianliang; RUAN Liangjing; DUAN Xia

doi:10.12102/j.issn.1009-6493.2026.05.012

Abstract：Objective:To summarize the best available evidence regarding fertility preservation decision-making for breast cancer patients of reproductive age,so as to provide a reference for supporting these patients making decisions.Methods:The databases and websites including UpToDate,BMJ Best Practice,Cochrane Library,JBI Evidence-Based Healthcare Center database,the UK National Institute for Health and Care Excellence(NICE),PubMed,Web of Science,and EMbase for evidence related to fertility preservation decision-making for breast cancer patients of reproductive age were systematically searched.The types of evidence sought included clinical decision support tools,guidelines,systematic reviews,evidence summaries,and expert consensus documents.The search period was from the inception of each database to Februry 18,2025.Two researchers with a background in evidence-based nursing independently conducted the literature quality assessment.Evidence meeting quality standards was then extracted and summarized,incorporating input from relevant professionals.Results:A total of 15 articles were included,comprising 2 clinical decision support documents,4 guidelines,3 expert consensuses,2 evidence summaries,and 4 systematic reviews.The summarized best evidence covers four key aspects:the fertility preservation decision-making team,pre-decision assessment,decision-making methods,and decision content,resulting in a total of 30 best evidence statements.Conclusions:The summarized best evidence provides an evidence-based foundation for clinical healthcare professionals to support fertility preservation decision-making in breast cancer patients of reproductive age.In clinical application,healthcare providers need to respect patients' reproductive intentions,continuously advance the decision-making process,and protect the fertility potential of breast cancer patients as much as possible.