American Board of Internal Medicine (ABIM) Certification Practice Exam

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For women being treated for breast cancer, when should referral to a fertility specialist occur?

After the initiation of chemotherapy
Before adjuvant chemotherapy
During radiation therapy
After surgery

The correct answer is: Before adjuvant chemotherapy

Referral to a fertility specialist before adjuvant chemotherapy is important for women being treated for breast cancer because chemotherapy can significantly impact fertility. This window allows women to consider options for preserving their fertility, such as egg or embryo freezing, before undergoing treatment that could compromise their reproductive capabilities. Timing is crucial, as initiating chemotherapy often results in hormonal changes and potential ovarian damage that can diminish or eliminate the chances of conceiving in the future. Engaging with a fertility expert prior to the start of chemotherapy enables patients to make informed decisions about their reproductive health and explore available options while still having time to act before the onset of treatment. This proactive approach is vital as once chemotherapy begins, preserving fertility becomes more challenging.