Here's something you might need to ask a medical oncologist about if you're going to be starting chemotherapy for breast cancer. A study recently published by the Dana Farber Cancer Institute found that the ability of premenopausal women to conceive could be impaired by chemotherapy.

We used to warn our patients that having a bone-marrow transplant would put a stop to ovulation afterwards. Now it looks like we also need to assess the fertility rates of women who are having the "lighter" chemotherapy that's more routinely offered these days.

We used to discourage women from getting pregnant altogether after breast cancer treatment, out of concern that high levels of estrogen during pregnancy might fuel a recurrence of the cancer.

But now that studies have shown that getting pregnant isn't as serious a problem for these women as we once thought, we need to seriously discuss with patients of child-bearing age just what their life plans are for expanding their families. This is especially important for women in their early 40s who may have chosen to delay starting a family.

If you or someone you know is in this situation - premenopausal, wanting to get pregnant, and about to start chemo - ask to meet with a medical oncologist experienced in fertility issues.